Congratulations to Drs. Subeikshanan Venkatesan, John Whalen and Giridhar Kalamangalam, on the publication of “Non-Tumoral Amygdalar Enlargement in Tumoral Epilepsy,” which appears in the March edition of World Neurosurgery.
Abstract
An 18-year-old left-handed African American male presented with a year-long history of seizures characterized by episodic palpitations, sweating, and agitation. Brain MRI revealed an enhancing tumor in the right anterior entorhinal cortex with adjacent amygdalar enlargement. Interictal magnetoencephalography and video-EEG confirmed lesional right temporal lobe epilepsy. The patient underwent a partial right anterior temporal lobectomy, with histopathology revealing WHO Grade 2 pleomorphic xanthoastrocytoma (PXA) with a BRAF V600E mutation. The amygdala showed no tumor infiltration, confirming reactive hyperplasia rather than neoplastic involvement. This case underscores the importance of distinguishing tumor infiltration from benign seizure-related amygdalar enlargement in long-term epilepsy-associated tumors (LEATs), usefully informing surgical strategy.