Objective: To describe a 61-year-old female who presents with abnormal tongue movement found to have right frontoparietal calcifying pseudoneoplasm of the neuraxis (CAPNON).

Background: CAPNON is a rare mass that can occur anywhere in the central nervous system. The cause of CAPNON is unclear and the histopathological findings reveal a calcified fibro-osseous lesion. Tongue fasciculations are an unusual presentation of this lesion.

Method: This is a single case report of a patient whose abnormal presentation and imaging yield the diagnosis of CAPNON. We participated in the multidisciplinary plan of care including chart review regarding this patient’s unique presentation, imaging, and pathological confirmation. There have been no previous case reports of CAPNON with this presentation.

Results: This is a unique case of tongue twitching and numbness lasting for two minutes over the course of two months. The unusual presentation warranted further investigation, including brain MRI revealing a right frontal lesion with edema and calcification. The imaging and pathology revealed findings of CAPNON. The lesion was removed with no complications.

Conclusion: This is the first reported case of CAPNON manifesting these symptoms. The lesion location does not relate to the presentation and more studies are needed to fully understand the pathology of the illness.

References: Miller, E. A. (1922). Calculi within the brain. Report of a case of intracranial calcification with successful operation and recovery. Surg Gynecol Obstet, 34, 786-789.

Ho ML, Eschbacher KL, Paolini MA, Raghunathan A. New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20-year radiological–pathological study of 37 cases. Histopathology. 2020;76(7):1055-1069. doi:10.1111/his.14066

Vallejo FA, Chen SH, Bano G, Gultekin S, Morcos J. Calcifying pseudoneoplasm of the neuroaxis presenting with refractory seizures: Case report and literature review. J Clin Neurosci Off J Neurosurg Soc Australas. 2020;78:439-443. doi:10.1016/j.jocn.2020.05.001

Nonaka Y, Aliabadi HR, Friedman AH, Odere FG, Fukushima T. Calcifying Pseudoneoplasms of the Skull Base Presenting with Cranial Neuropathies: Case Report and Literature Review. J Neurol Surg Rep. 2012;73(1):41-47. doi:10.1055/s-0032-1321503

Rhodes RH, Davis RL. An unusual fibro-osseous component in intracranial lesions. Hum Pathol. 1978 May;9(3):309-19. doi: 10.1016/s0046-8177(78)80088-4. PMID: 658964.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/tongue-fasciculations-and-numbness-a-case-of-calcifying-pseudoneoplasm/