Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

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  • 1 Departments of Radiology,
  • 2 Neurosurgery, and
  • 3 Pathology, Medical University of South Carolina, Charleston, South Carolina
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The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

ABBREVIATIONS JXG = juvenile xanthogranuloma; LCH = Langerhans cell histiocytosis.

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Contributor Notes

Correspondence Jacob A. Kahn: Medical University of South Carolina, Charleston, SC. kahnj@musc.edu.

INCLUDE WHEN CITING Published online July 17, 2020; DOI: 10.3171/2020.4.PEDS19624.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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