Differential diagnosis of a vanishing brain space occupying lesion in a child

Giant hydatid cyst of the brain: Intact cyst removal in 8-year-old child

INTRODUCTION AND IMPORTANCE

Cystic echinococcosis (hydatidosis) in humans is an infectious disease caused by tapeworms of Echinococcus genus. Brain involvement is rare. The best treatment is surgery and intact cyst removal is mandatory to prevent recurrence and possible anaphylactic reaction.

CASE PRESENTATION

An 8-year-old girl presented with a 1-month history of malaise, headache and vomiting. On Physical examinations, she was disoriented with bilateral papilledema. Brain CT scan and MRI revealed a well-defined cystic mass in left temporo-parieto-occipital region with considerable midline shift without perilesional edema. The patient was diagnosed with brain hydatid cyst and underwent surgical excision of the cyst without rupture.

CLINICAL DISCUSSION

Surgery is the most important part of intracranial hydatid cyst treatment, and surgeons should make every effort to remove them in toto without spillage. We hence decided to perform surgery and necessary precautions to prevent rupture and dissemination of hydatid were taken during the surgery.

CONCLUSION

A neurosurgeon has to bear in mind brain hydatid cyst in the differential diagnosis of cystic cerebral lesions especially in children from rural areas. The hydrodissection technique is the gold standard for the surgical treatment of cerebral hydatid cyst disease. It can also be effectively applied to the treatment of giant cerebral hydatid cyst disease without rupturing the cyst.

Spontaneous regression of congenital brain tumors: a report of two cases

BACKGROUND

Vanishing brain tumor is defined as spontaneously disappearing or decreasing of the initial brain mass volume to ≤ 70% before establishing the definitive diagnosis. The condition is rare and can be attributed to different factors. The exact mechanism is under debate, but the increasing rate and accuracy of neuroimaging studies and occurrence of similar scenario in other pathologies rather than brain tumors can be of particular importance in finding vanishing brain lesions.

CASE REPORT

We present two unusual cases of congenital brain masses which underwent spontaneous shrinkage within the first months of life.

CONCLUSION

The condition is scarcely observed in congenital brain masses. As congenital brain lesions are distinct entities with peculiar characteristics, this rare phenomenon may reflect different aspects in this age group.