A Multifocal Glioneuronal Tumor with RGNT-Like Morphology Occupying the Supratentorial Ventricular System and Infiltrating the Brain Parenchyma.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 05 07 2019
revised: 02 10 2019
accepted: 03 10 2019
pubmed: 14 10 2019
medline: 28 1 2020
entrez: 14 10 2019
Statut: ppublish

Résumé

Rosette-forming glioneuronal tumors (RGNTs) with multifocal growth throughout the ventricular system are extremely rare, and only 1 case of RGNT with dissemination limited to supratentorial ventricles has previously been reported. Recent evidence based on molecular data suggest that low-grade glioneuronal tumors (GNT) involving the septum pellucidum and the lateral ventricles, with either dysembryoplastic neuroepithelial tumor-like or RGNT-like features, may belong to a neuropathologic entity distinct from cortical dysembryoplastic neuroepithelial tumor and "typical" fourth ventricle RGNT, respectively. Given their rarity, the classification of these neoplasms is still uncertain and their clinicopathological and radiological aspects are only partially known. A 24-year-old male presented a GNT with RGNT-like morphological features centered in the septum pellucidum with multifocal masses occupying the lateral ventricles and the third ventricle with extraventricular infiltration of the frontal lobe. The patient underwent subtotal resection and 4 years follow-up. The clinicopathological and radiological features of the neoplasm are discussed. Advanced magnetic resonance imaging (magnetic resonance spectroscopy and perfusion-weighted imaging) may provide valuable information in the differential diagnosis between rare GNTs and other more frequent intraventricular neoplasms. In the present case, the enhancing remnant portion of the tumor showed remarkable contrast enhancement variability during the follow-up with slow in situ progression. However, available data suggest that spontaneous contrast enhancement "fluctuations" over time in RGNT may not represent a reliable indicator of tumor behavior.

Sections du résumé

BACKGROUND BACKGROUND
Rosette-forming glioneuronal tumors (RGNTs) with multifocal growth throughout the ventricular system are extremely rare, and only 1 case of RGNT with dissemination limited to supratentorial ventricles has previously been reported. Recent evidence based on molecular data suggest that low-grade glioneuronal tumors (GNT) involving the septum pellucidum and the lateral ventricles, with either dysembryoplastic neuroepithelial tumor-like or RGNT-like features, may belong to a neuropathologic entity distinct from cortical dysembryoplastic neuroepithelial tumor and "typical" fourth ventricle RGNT, respectively. Given their rarity, the classification of these neoplasms is still uncertain and their clinicopathological and radiological aspects are only partially known.
CASE DESCRIPTION METHODS
A 24-year-old male presented a GNT with RGNT-like morphological features centered in the septum pellucidum with multifocal masses occupying the lateral ventricles and the third ventricle with extraventricular infiltration of the frontal lobe. The patient underwent subtotal resection and 4 years follow-up. The clinicopathological and radiological features of the neoplasm are discussed.
CONCLUSIONS CONCLUSIONS
Advanced magnetic resonance imaging (magnetic resonance spectroscopy and perfusion-weighted imaging) may provide valuable information in the differential diagnosis between rare GNTs and other more frequent intraventricular neoplasms. In the present case, the enhancing remnant portion of the tumor showed remarkable contrast enhancement variability during the follow-up with slow in situ progression. However, available data suggest that spontaneous contrast enhancement "fluctuations" over time in RGNT may not represent a reliable indicator of tumor behavior.

Identifiants

pubmed: 31606508
pii: S1878-8750(19)32632-4
doi: 10.1016/j.wneu.2019.10.017
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

196-200

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Mauro Morassi (M)

Department of Radiology and Image Diagnostics, Neuroradiology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy. Electronic address: mauro.morassi@poliambulanza.it.

Oscar Vivaldi (O)

Department of Neurosurgery, Fondazione Poliambulanza Hospital, Brescia, Italy.

Milena Cobelli (M)

Department of Radiology and Image Diagnostics, Neuroradiology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy.

Barbara Liserre (B)

Department of Pathology, Fondazione Poliambulanza Hospital, Brescia, Italy.

Fausto Zorzi (F)

Department of Pathology, Fondazione Poliambulanza Hospital, Brescia, Italy.

Claudio Bnà (C)

Department of Radiology and Image Diagnostics, Neuroradiology Unit, Fondazione Poliambulanza Hospital, Brescia, Italy.

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