A supratentorial primary parenchymal paraganglioma.
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Primary intracerebral paraganglioma is an unusual entity in the diagnostic armamentarium of the neurosurgeon. Only two patients have been described with a supratentorial intra-parenchymal subtype. We report a 40-year-old man who presented with features of raised intracranial pressure and secondary visual deterioration of short duration. His MRI showed a 2 cm by 2 cm by 2.5 cm, brilliantly enhancing lesion in the left frontal region with flow voids and disproportionate perilesional edema. Magnetic resonance angiography demonstrated a "sun-burst" appearance. The lesion was totally excised, with subsequent resolution of symptoms. Histopathology was reported as a paraganglioma. The systemic workup confirmed the primary intracerebral nature of the lesion. To our knowledge, this report documents a hitherto undescribed, exclusive intraparenchymal location of a rare benign lesion.