The X-Files: June 2007

Marshall Deltoff
January 03, 2008
Written by Marshall Deltoff
This 48-year-old female presented with neck pain. Radiographs revealed a well-defined focus of flocculent calcification within the cranial vault, to the right of midline
46Thank you to my friend, Dr. Paul Charlton of Toronto, for this case.   

This 48-year-old female presented with neck pain. Radiographs revealed a well-defined focus of flocculent calcification within the cranial vault, to the right of midline, and just above the mastoid air cells and upper tip of the outer ear (Figures A and B).

Diagnosis:
Choroid plexus glomus calcification. Despite the dramatic appearance, this was an incidental finding with no clinical significance.

Discussion:
The choroid plexus is found along the floor of each lateral ventricle of the brain. It consists of vascular fringe-like folds in the pia mater. The choroid plexus is involved with the production of cerebrospinal fluid.

The glomus is a focal enlargement of the choroid plexus composed of fine arterioles connecting directly with veins. It is found at the posterior aspect of the floor of the ventricle, immediately anterior to the point of origin of the occipital horn.

Calcification of the glomus occurs in eight per cent of the normal adult population. On CAT scan, the frequency of observed calcification is greater due to the increased sensitivity of that imaging modality.

Differential diagnosis includes calcification within a tumour, or a calcified and displaced pineal gland (typically a much smaller focus of calcification).•

Reference:
Paul LW, Juhl JH.  Essentials of roentgen interpretation.  Hagerstown, Maryland: Harper & Row, 1972.

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