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Makino Y, Kojima M, Inokuchi G, Motomura A, Arai N, Inoue H, Kabasawa H, Iwase H, Yajima D. Two medicolegal autopsy cases of multinodular and vacuolating neuronal tumor revealed by postmortem MRI. Leg Med (Tokyo) 2024; 69:102342. [PMID: 37914604 DOI: 10.1016/j.legalmed.2023.102342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
The multinodular and vacuolating neuronal tumor (MVNT) is a recently recognized brain lesion. MVNT has a characteristic appearance in MRI images and is potentially epileptogenic. To the best of our knowledge, no report has yet described this pathological entity in the forensic medicine literature. We present two medicolegal autopsy cases where postmortem MRI (PMMR) was useful to detect this lesion. Case 1: a man in his 30s, with about a 7-year history of intractable epilepsy and known MVNT died suddenly. Although MVNT was not detected in the initial morphological evaluation during autopsy, PMMR of the formalin-fixed brain revealed the lesion in the left frontal lobe. Histopathology confirmed it as a MVNT. Case 2: a man in his 20s hanged himself to death. PMMR prior to autopsy revealed MVNT in his brain, and the diagnosis was confirmed by a detailed histopathological evaluation. In both cases, postmortem CT was not useful for evaluation. The cases suggested that MVNT can cause sudden, unexpected epileptic death, and pre- or post-autopsy PMMR may be useful to detect it.
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Affiliation(s)
- Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.
| | - Masatoshi Kojima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Go Inokuchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Ayumi Motomura
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita, Japan
| | - Nobutaka Arai
- Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, Japan
| | - Hiroyuki Inoue
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita, Japan
| | - Hiroyuki Kabasawa
- Department of Radiological Sciences, International University of Health and Welfare, 4-3 Kozunomori, Narita, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan
| | - Daisuke Yajima
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita, Japan
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2
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Pak A, Choi HJ, You SH, Yang KS, Kim B, Choi SH, Kim SH, Kim JY, Kim BK, Park SE, Ryoo I, Jung HN. Bright diffusion sign: A sensitive and specific radiologic biomarker for multinodular and vacuolating neuronal tumor. J Neuroradiol 2024; 51:101171. [PMID: 38168545 DOI: 10.1016/j.neurad.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND PURPOSE Accurate differentiation between multinodular and vacuolating neuronal tumor (MVNT) and dysembryoplastic neuroepithelial tumor (DNET) is important for treatment decision-making. We aimed to develop an accurate radiologic diagnostic model for differentiating MVNT from DNET using T2WI and diffusion-weighted imaging (DWI). MATERIALS AND METHODS A total of 56 patients (mean age, 47.48±17.78 years; 31 women) diagnosed with MVNT (n = 37) or DNET (n = 19) who underwent brain MRI, including T2WI and DWI, were included. Two board-certified neuroradiologists performed qualitative (bubble appearance, cortical involvement, bright diffusion sign, and bright apparent diffusion coefficient [ADC] sign) and quantitative (nDWI and nADC) assessments. A diagnostic tree model was developed with significant and reliable imaging findings using an exhaustive chi-squared Automatic Interaction Detector (CHAID) algorithm. RESULTS In visual assessment, the imaging features that showed high diagnostic accuracy and interobserver reliability were the bright diffusion sign and absence of cortical involvement (bright diffusion sign: accuracy, 94.64 %; sensitivity, 91.89 %; specificity, 100.00 %; interobserver agreement, 1.00; absence of cortical involvement: accuracy, 92.86 %; sensitivity, 89.19 %; specificity, 100.00 %; interobserver agreement, 1.00). In quantitative analysis, nDWI was significantly higher in MVNT than in DENT (1.52 ± 0.34 vs. 0.91 ± 0.27, p < 0.001), but the interobserver agreement was fair (intraclass correlation coefficient = 0.321). The overall diagnostic accuracy of the tree model with visual assessment parameters was 98.21 % (55/56). CONCLUSION The bright diffusion sign and absence of cortical involvement are accurate and reliable imaging findings for differentiating MVNT from DNET. By using simple, intuitive, and reliable imaging findings, such as the bright diffusion sign, MVNT can be accurately differentiated from DNET.
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Affiliation(s)
- Arim Pak
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hye Jeong Choi
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Sung-Hye You
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
| | - Kyung-Sook Yang
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Byungjun Kim
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sue-Hee Choi
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Sang Heum Kim
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Jung Youn Kim
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Bo Kyu Kim
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sang Eun Park
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Inseon Ryoo
- Department of Radiology, Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hye Na Jung
- Department of Radiology, Guro Hospital, Korea University College of Medicine, Seoul, South Korea
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Wang Z, Ma J. Case report: Rare case of multinodular and vacuolar neuronal tumors in the cerebellum. Front Neurol 2024; 14:1309209. [PMID: 38249731 PMCID: PMC10797035 DOI: 10.3389/fneur.2023.1309209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Multinodular and vacuolar neuronal tumor (MVNT) is a rare and benign neuroepithelial tumor. Most reports describe tumors located in the cerebral hemisphere. A literature review found that 15 cases were located in the posterior cranial fossa, but all lacked pathological evidence. In this case, a patient sought medical attention due to insomnia and irritability. Neuroepithelial tumors were found in the imaging, and the patient underwent radiation therapy. Three years later, malignant tumors were found upon imaging examination. After surgical resection and pathological testing, MVNT occurring in the cerebellum was diagnosed. MVNT is rare in the cerebellum, and direct imaging diagnosis becomes difficult after treatment. Therefore, our report of this case helps to further accurate understanding of the imaging, pathological, and molecular genetic changes occurring before and after MVNT treatment, and will improve the accuracy of pre-treatment diagnosis and reduce the likelihood of overtreatment.
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Affiliation(s)
| | - Jiwei Ma
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Biyikli E, Kursun M, Altuntas D, Bayri Y, Baltacioglu F. Radiological and clinical features of multinodular and vacuolating neuronal tumor (MVNT). EGYPTIAN JOURNAL OF NEUROSURGERY 2023. [DOI: 10.1186/s41984-022-00181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Abstract
Background
To investigate the imaging findings and clinical features of multinodular and vacuolating neuronal tumor (MVNT).
Methods
We retrospectively sought for cases that have suspicious imaging findings for MVNT through the hospital information system. The patients’ demographics and clinical symptoms were extracted. All available images were re-examined.
Results
Headache was the most common complaint (n = 7). Other complaints included seizure, stroke-like symptoms and numbness. Conventional MRI revealed that all lesions consisted of tiny, sharply marginated, round or ovoid nodules following the gyral contour. These nodules were hyperintense on T2 and FLAIR WI, hypointense on T1 WI. All lesions were characterized by a lack of enhancement and diffusion restriction. Mass effect and peripheral edema were not observed. MVNT presented as an incidental finding in one case who complained gynecomastia and had pituitary adenoma on pituitary MRI. All lesions were supratentorial—mostly on the right side (10/11)—and located in subcortical white matter. Follow-up MRI was available for 11 patients with a mean of 14.8 months (3–40 months). No change in lesion size and morphology was observed in these follow-up images.
Conclusions
Radiological and clinical follow-up data suggest MVNT may exhibit indolent behavior. If asymptomatic, patients can be followed by imaging alone. Surgery should be considered for symptomatic patients.
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Jesus-Ribeiro J, Rebelo O, Ribeiro IP, Pires LM, Melo JD, Sales F, Santana I, Freire A, Melo JB. The landscape of common genetic drivers and DNA methylation in low-grade (epilepsy-associated) neuroepithelial tumors: A review. Neuropathology 2022; 42:467-482. [PMID: 35844095 DOI: 10.1111/neup.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/05/2022] [Accepted: 06/05/2022] [Indexed: 12/15/2022]
Abstract
Low-grade neuroepithelial tumors (LNETs) represent an important group of central nervous system neoplasms, some of which may be associated to epilepsy. The concept of long-term epilepsy-associated tumors (LEATs) includes a heterogenous group of low-grade, cortically based tumors, associated to drug-resistant epilepsy, often requiring surgical treatment. LEATs entities can sometimes be poorly discriminated by histological features, precluding a confident classification in the absence of additional diagnostic tools. This study aimed to provide an updated review on the genomic findings and DNA methylation profiling advances in LNETs, including histological entities of LEATs. A comprehensive search strategy was conducted on PubMed, Embase, and Web of Science Core Collection. High-quality peer-reviewed original manuscripts and review articles with full-text in English, published between 2003 and 2022, were included. Results were screened based on titles and abstracts to determine suitability for inclusion, and when addressed the topic of the review was screened by full-text reading. Data extraction was performed through a qualitative content analysis approach. Most LNETs appear to be driven mainly by a single genomic abnormality and respective affected signaling pathway, including BRAF p.V600E mutations in ganglioglioma, FGFR1 abnormalities in dysembryoplastic neuroepithelial tumor, MYB alterations in angiocentric glioma, BRAF fusions in pilocytic astrocytoma, PRKCA fusions in papillary glioneuronal tumor, between others. However, these molecular alterations are not exclusive, with some overlap amongst different tumor histologies. Also, clustering analysis of DNA methylation profiles allowed the identification of biologically similar molecular groups that sometimes transcend conventional histopathological classification. The exciting developments on the molecular basis of these tumors reinforce the importance of an integrative histopathological and (epi)genetic classification, which can be translated into precision medicine approaches.
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Affiliation(s)
- Joana Jesus-Ribeiro
- Neurology Department, Centro Hospitalar de Leiria, Leiria, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olinda Rebelo
- Neuropathology Laboratory, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ilda Patrícia Ribeiro
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Luís Miguel Pires
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Daniel Melo
- Internal Medicine Department, CUF Coimbra Hospital, Coimbra, Portugal
| | - Francisco Sales
- Epilepsy and Sleep Monitoring Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - António Freire
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurology Department, Coimbra Luz Hospital, Coimbra, Portugal
| | - Joana Barbosa Melo
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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6
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2021 WHO classification of tumours of the central nervous system: a review for the neuroradiologist. Neuroradiology 2022; 64:1919-1950. [DOI: 10.1007/s00234-022-03008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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Arbuiso S, Roster K, Gill A, Tarawneh O, Cole KL, Kazim SF, Vellek J, Schmidt MH, Bowers CA. Multinodular and Vacuolating Neuronal Tumor: Incidental Diagnosis of a Rare Brain Lesion. Cureus 2021; 13:e20674. [PMID: 35106217 PMCID: PMC8786570 DOI: 10.7759/cureus.20674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
Multinodular and vacuolating neuronal tumor (MVNT) is a rare benign brain lesion, commonly found in middle-aged adults. The patients experience a range of symptoms from being asymptomatic to epileptic seizures, with headache being the most common symptom. Here we report a case of an incidental diagnosis of MVNT in a young female. A 25-year-old female with a past medical history of occasional headaches without seizures or any focal neurological deficit presented after a motor vehicle rollover. The MRI brain revealed an incidental finding of a subcortical lesion in the right parietal lobe with T2-FLAIR (fluid-attenuated inversion recovery) hyperintensity between the cystic portions, indicative of a possible MVNT, with a less probable chance of dysembryoplastic neuroepithelial tumor based on the subcortical location of the lesion. No neurosurgical intervention was recommended. With one-year follow-up, no changes were noted on neuroimaging, and the patient remained stable without any neurological symptoms. The MVNT is a rare brain lesion that presents with benign features. In patients with epileptic symptoms, surgical resection of the lesion can be curative. However, in asymptomatic patients, careful monitoring may be sufficient, as described in this case.
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8
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Alizada O, Ayman T, Akgun MY, Sar M, Urganci N, Kemerdere R. Multinodular and vacuolating neuronal tumor of the cerebrum: Two cases and review of the literature. Clin Neurol Neurosurg 2020; 197:106149. [PMID: 32979644 DOI: 10.1016/j.clineuro.2020.106149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/09/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multinodular and vacuolating neuronal tumor (MVNT) recently described as a purely neuronal tumor. Although its nature as a genuine tumor is controversial, this new entity assumed benign lesion and mostly affecting adults. Herein, we introduce two cases of MVNT presumed low grade glial tumor (LGG) and focal cortical dyplasia (FCD) as a differential diagnosis. CASE DESCRIPTION Case 1 has admitted to our hospital with headache which frequency and severity has increased within two months. Radiological examination revealed hyperintensity on T2-WI and T2 FLAIR images. Microsurgical resection was performed and histopathological findings were compatible with MVNT instead of low grade glial tumor as we thought. Case 2, who presented at our hospital with one episode seizure. MRI showed T2 hyperintensity and T1 hypointensity without contrast enhancement. We suspected FCD, thus performed microsurgical gross total resection with frontal craniotomy. Pathological findings confirmed MVNT as a diagnosis. Both cases were discharged on the 3rd day after surgery without any complications and with no regrowth of tumor at the 9-months and 3-months follow-up respectively. CONCLUSIONS Radiological hallmarks may be helpful to prevent from aggressive treatment in case of patient is asemptomatic. Nevertheless further studies are necessary for the adoption of 'wait and see' philosophy and give a verdict about benign nature of these tumors.
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Affiliation(s)
- Orkhan Alizada
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
| | - Tugce Ayman
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Mehmet Yigit Akgun
- Department of Neurosurgery, High Specialized Hospital, Kirikkale, Turkey
| | - Mehmet Sar
- Department of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Nil Urganci
- Department of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Rahsan Kemerdere
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
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9
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Nunes Dias L, Candela-Cantó S, Jou C, Aparicio Calvo J, García-García S, Mena-Bernal JH. Multinodular and vacuolating neuronal tumor associated with focal cortical dysplasia in a child with refractory epilepsy: a case report and brief review of literature. Childs Nerv Syst 2020; 36:1557-1561. [PMID: 31950248 DOI: 10.1007/s00381-019-04496-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
Multinodular and vacuolating neuronal tumor (MVNT) is a rare newly identified benign lesion, firstly included in the World Health Organization classification of tumors of the central nervous system in 2016, whose neoplastic or dysplastic nature remains unclear but with a distinctive cytoarchitectural pattern and radiological features. It is usually discovered as late-onset refractory epilepsy, headache related, or an incidental lesion of adulthood. As it is typically a stable disease, many opt for follow-up, as long as it keeps remaining asymptomatic, leaving surgery for refractory epilepsy, neurological deficits, or intracranial hypertension symptoms. A subtotal or complete resection seems to control seizures and neurological manifestations. We herein present the case of a child with refractory epilepsy related to MVNT and focal cortical dysplasia, a dual pathology case in a less frequent age group and without the typical radiological imaging. We report its radiologic features, histologic description, and management, and we present a brief literature review on MVNT focusing on the pediatric cases reported. MVNT should now be another probable low-grade epilepsy-associated lesion (LEAT) in patients of all ages, with a benign and stable course as it constitutes a curable cause of focal epilepsy. As all the refractory cases, surgery should be indicated after a comprehensive evaluation of a multidisciplinary epilepsy surgery team.
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Affiliation(s)
- Lídia Nunes Dias
- Department of Neurosurgery, Hospital Egas Moniz - Centro Hospitalar Lisboa Ocidental EPE, Rua da Junqueira 126, 1349-019, Lisbon, Portugal.
| | - Santiago Candela-Cantó
- Department of Neurosurgery, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain.,Epilepsy Surgery Unit, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain
| | - Cristina Jou
- Department of Pathology, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain
| | - Javier Aparicio Calvo
- Epilepsy Surgery Unit, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain.,Department of Pathology, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain
| | - Sergio García-García
- Department of Neurosurgery, Sant Joan de Déu Barcelona Children's Hospital, Barcelona, Spain
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Lecler A, Broquet V, Bailleux J, Carsin B, Adle-Biassette H, Baloglu S, Forestier G, Bonneville F, Calvier E, Chauvet D, Comby PO, Cottier JP, Cotton F, Deschamps R, Diard-Detoeuf C, Ducray F, Drissi C, Elmaleh M, Farras J, Aguilar Garcia J, Gerardin E, Grand S, Jianu DC, Kremer S, Loiseau H, Magne N, Mejdoubi M, Moulignier A, Ollivier M, Nagi S, Rodallec M, Shor N, Tourdias T, Vandendries C, Anxionnat R, Duron L, Savatovsky J. Advanced multiparametric magnetic resonance imaging of multinodular and vacuolating neuronal tumor. Eur J Neurol 2020; 27:1561-1569. [PMID: 32301260 DOI: 10.1111/ene.14264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/10/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a rare brain lesion with suggestive imaging features. The aim of our study was to report the largest series of MVNTs so far and to evaluate the utility of advanced multiparametric magnetic resonance (MR) techniques. METHODS This multicenter retrospective study was approved by our institutional research ethics board. From July 2014 to May 2019, two radiologists read in consensus the MR examinations of patients presenting with a lesion suggestive of an MVNT. They analyzed the lesions' MR characteristics on structural images and advanced multiparametric MR imaging. RESULTS A total of 64 patients (29 women and 35 men, mean age 44.2 ± 15.1 years) from 25 centers were included. Lesions were all hyperintense on fluid-attenuated inversion recovery and T2-weighted imaging without post-contrast enhancement. The median relative apparent diffusion coefficient on diffusion-weighted imaging was 1.13 [interquartile range (IQR), 0.2]. Perfusion-weighted imaging showed no increase in perfusion, with a relative cerebral blood volume of 1.02 (IQR, 0.05) and a relative cerebral blood flow of 1.01 (IQR, 0.08). MR spectroscopy showed no abnormal peaks. Median follow-up was 2 (IQR, 1.2) years, without any changes in size. CONCLUSIONS A comprehensive characterization protocol including advanced multiparametric magnetic resonance imaging sequences showed no imaging patterns suggestive of malignancy in MVNTs. It might be useful to better characterize MVNTs.
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Affiliation(s)
- A Lecler
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - V Broquet
- Department of Neuroradiology, CHU Lille, Lille, France
| | - J Bailleux
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - B Carsin
- Department of Radiology, CHRU de Rennes, Rennes, France
| | - H Adle-Biassette
- Department of Pathology, Lariboisière Hospital, Paris Diderot, Paris-Cité-Sorbonne University, Paris, France
| | - S Baloglu
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - G Forestier
- Department of Neuroradiology, CHU Limoges, Limoges, France
| | - F Bonneville
- Department of Neuroradiology, Hôpital Pierre-Paul-Riquet, CHU Purpan, Toulouse, France
| | - E Calvier
- Neurology Department, Hôpital René et Guillaume-Laënnec, CHU de Nantes, Saint-Herblain, France
| | - D Chauvet
- Department of Neurosurgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - P O Comby
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon, France
| | - J P Cottier
- Department of Radiology, CHRU de Tours, Tours, France.,Brain and Imaging laboratory, UMR U930, INSERM, François-Rabelais University, Tours, France
| | - F Cotton
- Service de Radiologie, Centre Hospitalier Lyon-Sud, 69495 Pierre-Bénite, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - R Deschamps
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | | | - F Ducray
- Department of Neuro-oncology, Lyon French Reference Center of Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Lyon, France
| | - C Drissi
- Faculté de Médecine de Tunis, Institut National de Neurologie, Service de Neuroradiologie, Université de Tunis El Manar, Tunis, Tunisia
| | - M Elmaleh
- Pediatric Radiology Department, Robert Debré Hospital, Paris, France
| | - J Farras
- Jordi Radiologia C/ de la Roda, Andorra la Vella, Andorra
| | - J Aguilar Garcia
- Neurology Department, Hôpital René et Guillaume-Laënnec, CHU de Nantes, Saint-Herblain, France
| | - E Gerardin
- Department of Neuroradiology and MRI, Rouen University Hospital, Rouen, France
| | - S Grand
- Neuroradiologie diagnostique et interventionnelle et IRM Nord 'Centre Hospitalier et Universitaire de Alpes Grenoble', Grenoble, France
| | - D C Jianu
- Department of Neurology, Victor Babes University of Medecine and Pharmacy, Timisoara, Romania
| | - S Kremer
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - H Loiseau
- Service de Neurochirurgie, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - N Magne
- Department of Neuroradiology and MRI, Rouen University Hospital, Rouen, France
| | - M Mejdoubi
- Department of Neuroradiology, University Hospital of Martinique, Fort-de-France, France
| | - A Moulignier
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - M Ollivier
- Service de Radiologie, Groupe Hospitalier Pellegrin, Bordeaux, France
| | - S Nagi
- Faculté de Médecine de Tunis, Institut National de Neurologie, Service de Neuroradiologie, Université de Tunis El Manar, Tunis, Tunisia.,Clinique les Berges du Lac, rue du Lac de Constance, Tunis, Tunisia
| | - M Rodallec
- Centre d'Imagerie Centre Cardiologique du Nord, CCN, Saint-Denis, France
| | - N Shor
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - T Tourdias
- Service de Neuroimagerie Diagnostique et Thérapeutique, CHU de Bordeaux et INSERM U1215, Université de Bordeaux, Bordeaux, France
| | - C Vandendries
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Centre d'Imagerie Médicale Paris 15ème, RMX, Paris, France
| | - R Anxionnat
- Service de Radiologie, CHU de Nancy, Nancy, France
| | - L Duron
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - J Savatovsky
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Centre d'Imagerie Paris 13, Paris, France
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Gökçe E. Magnetic resonance imaging findings of two cases with multinodular and vacuolating neuronal tumor. Acta Neurol Belg 2020; 120:457-461. [PMID: 29243173 DOI: 10.1007/s13760-017-0872-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
Abstract
Multinodular and vacuolating neuronal tumors (MVNT) are low grade neuronal tumors classified in cerebral tumors based on 2016 WHO central nerve system classification. Previously, MVNTs were probably tumors incidentally determined by imaging methods, but they could not be diagnosed or they were misdiagnosed. Two cases are reported in the present study, for which radiological imaging was carried out for epilepsy in one and for headache in the other. The first case was a twenty seven years old female patient with headache complaint. Brain MRI examination revealed a clustering lesion of multinodular character located in an about 4.0 × 3.5 × 1.5 cm area which had a left precuneal subcortical-juxtacortical location. The other case was a male patient with epilepsy. A clustering lesion of multinodular nature was determined in an area of about 2.0 × 2.0 × 1.5 cm in cortical-subcortical area in corona radiata-convexity plane of right middle frontal girus. No changes in size or nature were determined in follow-up examinations. MVNTs are recently defined tumors, and the characteristic feature for diagnosis of these rare tumor entities could be a subcortical white matter lesion with satellite nodules that manifest itself as T2/FLAIRhyperintensity. Increasing number of case reports and studies in the literature could make the radiological and pathological signs of the condition clearer.
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12
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Kodama S, Shirota Y, Hagiwara A, Otsuka J, Sato K, Sugiyama Y, Mori H, Watanabe M, Hamada M, Toda T. Multinodular and vacuolating neuronal tumor (MVNT): A presumably incidental and asymptomatic case in an intractable epilepsy patient. Clin Neurophysiol Pract 2019; 4:164-167. [PMID: 31886439 PMCID: PMC6921157 DOI: 10.1016/j.cnp.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/18/2019] [Accepted: 05/13/2019] [Indexed: 11/15/2022] Open
Abstract
Multinodular vacuolating neuronal tumor (MVNT) was initially reported as epilepsy-related brain tumor. MVNT can exist as incidental and asymptomatic lesions in some cases. It is not always necessary to perform surgical resection of MVNT even in patients with epilepsy.
Introduction Multinodular and vacuolating neuronal tumor (MVNT) had been initially described as an epilepsy-related brain tumor, but recent studies demonstrated it could be found incidentally in non-epilepsy patients. Case report A 33-year-old woman with intractable post-encephalitis epilepsy presented a cluster of multinodular T2 hyperintensity in the left temporal lobe, which was very similar to the characteristics of MVNT. Long-term video electroencephalogram demonstrated that the habitual seizures were originated from bilateral temporal area and the interictal epileptic discharges were seen multifocally, although the lesions with MVNT appearance were localized in the left temporal lobe. It was presumed that the epilepsy in this patient was due to encephalitis in the past, and the link between the lesions and the epilepsy in this patient seemed weak. Conclusion Although MVNT had been considered as an epilepsy-related brain tumor, we suggest it is not necessarily preferable to perform surgical resection of MVNT even on patients with epilepsy, unless epileptic foci are highly related to MVNT.
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Affiliation(s)
- Satoshi Kodama
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yuichiro Shirota
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akifumi Hagiwara
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Juuri Otsuka
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kazuya Sato
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yusuke Sugiyama
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masako Watanabe
- Shinjuku Neuro Clinic, 3-21-18 Hyakunincho, Shinjuku-ku, Tokyo 169-0073, Japan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tatsushi Toda
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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13
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Lecler A, Bailleux J, Carsin B, Adle-Biassette H, Baloglu S, Bogey C, Bonneville F, Calvier E, Comby PO, Cottier JP, Cotton F, Deschamps R, Diard-Detoeuf C, Ducray F, Duron L, Drissi C, Elmaleh M, Farras J, Garcia JA, Gerardin E, Grand S, Jianu DC, Kremer S, Magne N, Mejdoubi M, Moulignier A, Ollivier M, Nagi S, Rodallec M, Sadik JC, Shor N, Tourdias T, Vandendries C, Broquet V, Savatovsky J. Multinodular and Vacuolating Posterior Fossa Lesions of Unknown Significance. AJNR Am J Neuroradiol 2019; 40:1689-1694. [PMID: 31558497 DOI: 10.3174/ajnr.a6223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/27/2019] [Indexed: 12/15/2022]
Abstract
Multinodular and vacuolating neuronal tumor of the cerebrum is a rare supratentorial brain tumor described for the first time in 2013. Here, we report 11 cases of infratentorial lesions showing similar striking imaging features consisting of a cluster of low T1-weighted imaging and high T2-FLAIR signal intensity nodules, which we referred to as multinodular and vacuolating posterior fossa lesions of unknown significance. No relationship was found between the location of the lesion and clinical symptoms. A T2-FLAIR hypointense central dot sign was present in images of 9/11 (82%) patients. Cortical involvement was present in 2/11 (18%) of patients. Only 1 nodule of 1 multinodular and vacuolating posterior fossa lesion of unknown significance showed enhancement on postcontrast T1WI. DWI, SWI, MRS, and PWI showed no malignant pattern. Lesions did not change in size or signal during a median follow-up of 3 years, suggesting that multinodular and vacuolating posterior fossa lesions of unknown significance are benign malformative lesions that do not require surgical intervention or removal.
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Affiliation(s)
- A Lecler
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.)
| | - J Bailleux
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.)
| | - B Carsin
- Department of Radiology (B.C., J.S.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France
| | - H Adle-Biassette
- Department of Pathology (H.A.-B.), Lariboisière Hospital, Paris Diderot, Paris-Cité-Sorbonne University, Paris, France
| | - S Baloglu
- Department of Radiology (S.B., S.K.), University Hospital of Strasbourg, Strasbourg, France
| | - C Bogey
- Department of Neuroradiology (C.B.), Centre Hospitalier Universitaire Limoges, Limoges, France
| | - F Bonneville
- Department of Neuroradiology (F.B.), Hôpital Pierre-Paul-Riquet, Centre Hospitalier Universitaire Purpan, Toulouse, France
| | - E Calvier
- Neurology Department (E.C., J.A.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France
| | - P-O Comby
- Department of Vascular and Interventional Radiology (P.-O.C.), Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon Cedex, France
| | - J-P Cottier
- Department of Radiology (J.-P.C.), Centre Hospitalier Régional Universitaire de Tours, Tours, France.,Brain and Imaging Laboratory (J.-P.C.), UMR U930, National Institute for Health and Medical Research, François-Rabelais University, Tours, France
| | - F Cotton
- Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.,Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS) (F.C.), National Institute for Health and Medical Research U1044/Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 5220, Lyon, France
| | - R Deschamps
- Neurology (R.D., A.M.), Fondation Ophtalmologique A. Rothschild, Paris, France
| | - C Diard-Detoeuf
- Department of Neurology (C.D.-D.), CH Sainte-Périne, Paris, France
| | - F Ducray
- Department of Neuro-Oncology (F.D.), Lyon French Reference Center of Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron Cedex, France.,Synatac Team (F.D.), NeuroMyoGene Institut, National Institute for Health and Medical Research U1217/Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 5310, Lyon, France.,University Claude Bernard Lyon 1 (F.D.), Lyon, France
| | - L Duron
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.)
| | - C Drissi
- Institut National de Neurologie (C.D., S.N.), Service de Neuroradiologie, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
| | - M Elmaleh
- Pediatric Radiology Department (M.E.), Robert Debré Hospital, Paris, France
| | - J Farras
- Jordi Radiologia C/de la Roda (J.F.), Andorra la Vella, Andorra
| | - J A Garcia
- Neurology Department (E.C., J.A.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France
| | - E Gerardin
- Department of Neuroradiology and MRI (E.G., N.M.), Rouen University Hospital, Rouen, France
| | - S Grand
- Neuroradiologie Diagnostique et Interventionnelle et IRM Nord (S.G.), Centre Hospitalier et Universitaire de Alpes Grenoble, Grenoble, France
| | - D C Jianu
- Department of Neurology (D.C.J.), Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - S Kremer
- Department of Radiology (S.B., S.K.), University Hospital of Strasbourg, Strasbourg, France
| | - N Magne
- Department of Neuroradiology and MRI (E.G., N.M.), Rouen University Hospital, Rouen, France
| | - M Mejdoubi
- Department of Neuroradiology (M.M.), University Hospital of Martinique, Fort-de-France, Martinique, France
| | - A Moulignier
- Neurology (R.D., A.M.), Fondation Ophtalmologique A. Rothschild, Paris, France
| | - M Ollivier
- Groupe Hospitalier Pellegrin (M.O.), Bordeaux, France
| | - S Nagi
- Institut National de Neurologie (C.D., S.N.), Service de Neuroradiologie, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia.,Clinique les Berges du Lac (S.N.), les Berges du Lac, Tunis, Tunisia
| | - M Rodallec
- Centre d'Imagerie Centre Cardiologique du Nord (M.R.), CCN, Saint-Denis, France
| | - J-C Sadik
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.)
| | - N Shor
- Department of Neuroradiology (N.S.), Pitié-Salpêtrière Hospital, Paris, France
| | - T Tourdias
- Service de Neuroimagerie Diagnostique et Thérapeutique (T.T.), Centre Hospitalier Universitaire de Bordeaux et National Institute for Health and Medical Research U1215, Université de Bordeaux, Bordeaux, France
| | - C Vandendries
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.).,Centre d'Imagerie Médicale Paris 15ème (C.V.), RMX, Paris, France
| | - V Broquet
- Department of Neuroradiology (V.B.), Centre Hospitalier Universitaire Lille, Lille, France
| | - J Savatovsky
- From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.).,Department of Radiology (B.C., J.S.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France.,Imagerie Paris 13 (J.S.), Paris, France
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14
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Buffa GB, Chaves H, Serra MM, Stefanoff NI, Gagliardo AS, Yañez P. Multinodular and Vacuolating Neuronal Tumor of the Cerebrum (MVNT): A case series and review of the literature. J Neuroradiol 2019; 47:216-220. [PMID: 31229580 DOI: 10.1016/j.neurad.2019.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE Multinodular and Vacuolating Neuronal Tumor of the cerebrum (MVNT) is a benign -seizure associated- lesion affecting mostly adults. This new entity has been included in the 2016 World Health Organization classification of tumors of the central nervous system. Its pathologic hallmark consist of a subcortical cluster of nodular lesions located on the subcortical white matter. We aim to report a series of cases of presumed MVNT observed in our institution and review the literature. MATERIALS AND METHODS In this retrospective study, a search was performed on our hospital information system. Sixteen cases were included. Demographic, clinical and radiological features were detailed in a table. All patients had an MRI acquired either on a 1.5 or a 3 Tesla scanner. Sequences performed included T1, T2, GRE/SWI, T2 FLAIR and DWI. Gadolinium enhanced T1-WI wer available in 11 patients and follow-up MRI were available in 7 patients. RESULTS Patient ages ranged from 16 to 77 years (mean 42 years). Seizure and non-focal headache were by far the most common neurological complaints for which MRI was requested. All lesions consisted of clusters of multiple, discrete, round or ovoid, intra-axial, FLAIR and T2-WI hyperintense nodules. Follow-up MRI scans showed no changes between studies. CONCLUSIONS MVNT is a benign, stable lesion that exhibits a typical radiological pattern that most of the times sufficed to arrive to a diagnosis, without the need of pathological confirmation. We confirm that our demographic, clinical and radiological findings are in accordance with those published in international literature.
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Affiliation(s)
- Geraldine Belén Buffa
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina
| | - Hernán Chaves
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Mercedes Serra
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina
| | - Nadia Ivanna Stefanoff
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina
| | - Allan Salvatore Gagliardo
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina
| | - Paulina Yañez
- Departamento de Diagnóstico por Imágenes, FLENI. Montañeses 2325 (C1428AQK), Ciudad Autónoma de Buenos Aires, Argentina
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15
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Choi E, Kim SI, Won JK, Chung CK, Kim SK, Choi SH, Choi S, Han B, Ahn B, Im SW, Park SH. Clinicopathological and molecular analysis of multinodular and vacuolating neuronal tumors of the cerebrum. Hum Pathol 2018; 86:203-212. [PMID: 30550736 DOI: 10.1016/j.humpath.2018.11.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/23/2018] [Accepted: 11/30/2018] [Indexed: 11/18/2022]
Abstract
Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a recently recognized rare neuronal tumor, and its pathogenesis is unclear. We analyzed 7 cases of histologically typical MVNT: 6 were adults (mean age, 43.0 years [range, 23-56 years]) and 1 was a child (age, 10 years). The most common symptoms were seizures (n = 4) and headache (n = 2). The tumors were supratentorial (temporal, 5; frontal lobes, 2) in origin as reported. Vacuolated tumor cells were robustly positive for α-INA and Olig2 and at least partly positive for synaptophysin and MAP2, but negative for Neu-N, nestin and CD34. GFAP and vimentin were expressed in reactive astrocytes but not in tumor cells. Negative results were obtained for p53, IDH-1, BRAFV600E, H3 K27M, EGFR, Lin28A, and L1CAM. ATRX, BRG1, INI-1, and TMHH were retained. The Ki-67 labeling index was very low (<1%), and pHH3 revealed no mitotic figure. Ultrastructural features of tumor cells were comparable with those of immature neuronal cells, with several intracytoplasmic myelin-like autophagosomes and pericellular vacuolization. No IDH1/IDH2 and BRAFV600E mutations were found upon direct sequencing. Whole-exome sequencing revealed FGFR2-ZMYND11 gene fusion in 1 case. After gross total resection, all patients were alive without seizures. There was no tumor recurrence during an average period of 68 months (range, 23-101 months). The analysis of 7 typical cases of MVNT suggested that these lesions may be clonal tumors because FGFR2-ZMYND11 fusion was found (1 case).
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Affiliation(s)
- Euno Choi
- Department of Pathology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Seonk-Ik Kim
- Department of Pathology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jae-Kyung Won
- Department of Pathology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Seung Ki Kim
- Department of Neurosurgery, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Seung-Hong Choi
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Seongmin Choi
- Division of Clinical Bioinformatics, Biomedical Research Institute, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Bome Han
- Department of Bioinformatics, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Bokyung Ahn
- Department of Pathology, Korea University Hospital, College of Medicine, Seoul 02842, Republic of Korea
| | - Sun-Wha Im
- Department of Biochemistry, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Neuroscience, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
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16
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Makrakis D, Veneris S, Papadaki E. Multinodular and vacuolating neuronal tumor incidentally discovered in a young man: Conventional and advanced MRI features. Radiol Case Rep 2018; 13:960-964. [PMID: 30108675 PMCID: PMC6083006 DOI: 10.1016/j.radcr.2018.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/06/2018] [Accepted: 07/08/2018] [Indexed: 11/12/2022] Open
Abstract
Multinodular and Vacuolating Neuronal Tumor (MVNT) has been included in the most recent (2016) World Health Organization Classification of Tumors of the Central Nervous System as unique cytoarchitectural pattern of gangliocytoma. We present a case of a MVNT incidentally discovered in a 22-year old male, who presented with seizures after a head injury. Conventional MRI revealed a left parietal lesion with characteristic tiny, coalescent, well-defined, non-enhancing nodules, located in the juxtacortical white matter with partial involvement of an otherwise normal adjacent cortex and characterized by slight relative increase of the cerebral blood volume (CBV), compared to the contralateral white matter (lesional CBV/contralateral CBV = 1.112) and mild increase of choline and reduction of NAA (lesional choline/creatine ratio =1.36 and choline/NAA ratio=0.77, compared to 0.87 and 0.51, respectively). The patient fully responded to treatment with phenytoin and a follow-up MRI, six months later, showed the lesion without any substantial difference.
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Affiliation(s)
- Dimitrios Makrakis
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stefanos Veneris
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
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17
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Shitara S, Tokime T, Akiyama Y. Multinodular and vacuolating neuronal tumor: A case report and literature review. Surg Neurol Int 2018; 9:63. [PMID: 29629230 PMCID: PMC5875109 DOI: 10.4103/sni.sni_348_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 02/03/2018] [Indexed: 11/15/2022] Open
Abstract
Background: Multinodular and vacuolated neuronal tumor (MVNT) is a benign neuronal tumor that is newly recognized as architectural appearance that may be related to ganglion cell tumors in 2016 World Health Organization Classification of Tumors of the Central Nervous System. Herein, we report a case of MVNT in a 60-year-old man with a thorough literature review. Case Description: A 60-year-old male was pointed out the presence of intracerebral neoplasm located in left frontal lobe by a comprehensive medical examination. We suspected dysembryoplastic neuroepithelial tumors and proposed him to wait and see, but he wished to undergo surgery for diagnosis. We performed en bloc resection and pathological findings were consistent with MVNT. He was discharged on the 8th day after the operation without any complications. He remained stable without recurrence at the 16-month postoperative follow-up. Conclusions: Further studies may be helpful to fully understand the radiological and histological findings of MVNT development. As a result, we will be able to prevent the aggressive treatment if we established their major features.
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Affiliation(s)
- Satoshi Shitara
- Department of Neurosurgery, Tenri Hospital, Tenri, Nara, Japan
| | - Tomoo Tokime
- Department of Neurosurgery, Tenri Hospital, Tenri, Nara, Japan
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18
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Stone TJ, Rowell R, Jayasekera BAP, Cunningham MO, Jacques TS. Review: Molecular characteristics of long-term epilepsy-associated tumours (LEATs) and mechanisms for tumour-related epilepsy (TRE). Neuropathol Appl Neurobiol 2018; 44:56-69. [DOI: 10.1111/nan.12459] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 12/22/2017] [Indexed: 12/14/2022]
Affiliation(s)
- T. J. Stone
- Developmental Biology and Cancer Programme; UCL Great Ormond Street Institute of Child Health; London UK
- Department of Histopathology; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - R. Rowell
- Institute of Neuroscience; Newcastle University; Newcastle Upon Tyne UK
- Department of Neurosurgery; Royal Victoria Hospital; Newcastle Upon Tyne UK
| | - B. A. P. Jayasekera
- Institute of Neuroscience; Newcastle University; Newcastle Upon Tyne UK
- Department of Neurosurgery; Royal Victoria Hospital; Newcastle Upon Tyne UK
| | - M. O. Cunningham
- Institute of Neuroscience; Newcastle University; Newcastle Upon Tyne UK
- Department of Neurosurgery; Royal Victoria Hospital; Newcastle Upon Tyne UK
| | - T. S. Jacques
- Developmental Biology and Cancer Programme; UCL Great Ormond Street Institute of Child Health; London UK
- Department of Histopathology; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
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19
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Lecler A, Chauvet D, Biassette HA, Savatovsky J. Multiparametric Imaging Improves Confidence in the Diagnosis of Multinodular and Vacuolating Neuronal Tumor of the Cerebrum. AJNR Am J Neuroradiol 2018; 39:E32-E33. [PMID: 29051207 DOI: 10.3174/ajnr.a5425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - D Chauvet
- Department of Neurosurgery Fondation Ophtalmologique Adolphe de Rothschild Paris, France
| | - H A Biassette
- Department of Pathology Lariboisière Hospital, Paris-Diderot, Paris-Cité-Sorbonne University Paris, France
| | - J Savatovsky
- Department of Radiology Fondation Ophtalmologique Adolphe de Rothschild Paris, France
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20
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Lobo R, Srinivasan A. Case of the Season: Multinodular and Vacuolating Neuronal Tumor. Semin Roentgenol 2018; 53:3-5. [DOI: 10.1053/j.ro.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Gonzalez-Quarante LH, Ruiz-Juretschke F, Sola Vendrell E, Gil de Sagredo del Corral OL, Agarwal V, Garcia-Leal R. Multinodular and vacuolating neuronal tumor of the cerebrum. A rare entity. New case and review of the literature. Neurocirugia (Astur) 2018; 29:44-55. [DOI: 10.1016/j.neucir.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 08/12/2017] [Accepted: 08/29/2017] [Indexed: 12/13/2022]
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22
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Johnson DR, Guerin JB, Giannini C, Morris JM, Eckel LJ, Kaufmann TJ. 2016 Updates to the WHO Brain Tumor Classification System: What the Radiologist Needs to Know. Radiographics 2017; 37:2164-2180. [DOI: 10.1148/rg.2017170037] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Derek R. Johnson
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Julie B. Guerin
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Caterina Giannini
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Jonathan M. Morris
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Lawrence J. Eckel
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Timothy J. Kaufmann
- From the Department of Radiology (D.R.J., J.B.G., J.M.M., L.J.E., T.J.K.) and Department of Laboratory Medicine and Pathology (C.G.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
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23
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Alsufayan R, Alcaide-Leon P, de Tilly LN, Mandell DM, Krings T. Presumptive diagnosis of multinodular vacuolating tumor: "More than meets the eye!". Neuroradiology 2017; 59:1069-1070. [PMID: 28920173 DOI: 10.1007/s00234-017-1924-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Reema Alsufayan
- Department of Medical Imaging - Division of Neuroradiology, University of Toronto, Toronto, ON, Canada
| | - Paula Alcaide-Leon
- Department of Medical Imaging - Division of Neuroradiology, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Lyne Noel de Tilly
- Department of Medical Imaging - Division of Neuroradiology, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Daniel M Mandell
- UHN Division of Neuroradiology, University of Toronto, Toronto Western Hospital, 399 Bathurst St., 3MCL-429, Toronto, ON, M5T 2S8, Canada
| | - Timo Krings
- UHN Division of Neuroradiology, University of Toronto, Toronto Western Hospital, 399 Bathurst St., 3MCL-429, Toronto, ON, M5T 2S8, Canada.
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24
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Thom M, Liu J, Bongaarts A, Reinten RJ, Paradiso B, Jäger HR, Reeves C, Somani A, An S, Marsdon D, McEvoy A, Miserocchi A, Thorne L, Newman F, Bucur S, Honavar M, Jacques T, Aronica E. Multinodular and vacuolating neuronal tumors in epilepsy: dysplasia or neoplasia? Brain Pathol 2017; 28:155-171. [PMID: 28833756 PMCID: PMC5887881 DOI: 10.1111/bpa.12555] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/27/2017] [Accepted: 08/01/2017] [Indexed: 12/28/2022] Open
Abstract
Multinodular and vacuolating neuronal tumor (MVNT) is a new pattern of neuronal tumour included in the recently revised WHO 2016 classification of tumors of the CNS. There are 15 reports in the literature to date. They are typically associated with late onset epilepsy and a neoplastic vs. malformative biology has been questioned. We present a series of ten cases and compare their pathological and genetic features to better characterized epilepsy‐associated malformations including focal cortical dysplasia type II (FCDII) and low‐grade epilepsy‐associated tumors (LEAT). Clinical and neuroradiology data were reviewed and a broad immunohistochemistry panel was applied to explore neuronal and glial differentiation, interneuronal populations, mTOR pathway activation and neurodegenerative changes. Next generation sequencing was performed for targeted multi‐gene analysis to identify mutations common to epilepsy lesions including FCDII and LEAT. All of the surgical cases in this series presented with seizures, and were located in the temporal lobe. There was a lack of any progressive changes on serial pre‐operative MRI and a mean age at surgery of 45 years. The vacuolated cells of the lesion expressed mature neuronal markers (neurofilament/SMI32, MAP2, synaptophysin). Prominent labelling of the lesional cells for developmentally regulated proteins (OTX1, TBR1, SOX2, MAP1b, CD34, GFAPδ) and oligodendroglial lineage markers (OLIG2, SMI94) was observed. No mutations were detected in the mTOR pathway genes, BRAF, FGFR1 or MYB. Clinical, pathological and genetic data could indicate that MVNT aligns more with a malformative lesion than a true neoplasm with origin from a progenitor neuro‐glial cell type showing aberrant maturation.
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Affiliation(s)
- Maria Thom
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Joan Liu
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Anika Bongaarts
- Department of (Neuro)Pathology, Academic Medical Center, Amsterdam, The Netherlands
| | - Roy J Reinten
- Department of (Neuro)Pathology, Academic Medical Center, Amsterdam, The Netherlands
| | - Beatrice Paradiso
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK.,Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences University of Padua Medical School, Padova, Italy
| | - Hans Rolf Jäger
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Cheryl Reeves
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Alyma Somani
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Shu An
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Derek Marsdon
- Departments of Clinical and Experimental Epilepsy and Neuropathology, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London WCN1BG, UK
| | - Andrew McEvoy
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Anna Miserocchi
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Lewis Thorne
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Fay Newman
- Neurosurgery Department, Brighton and Sussex University Hospitals, Brighton, UK
| | - Sorin Bucur
- Neurosurgery Department, Brighton and Sussex University Hospitals, Brighton, UK
| | - Mrinalini Honavar
- Department of Anatomic Pathology, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Tom Jacques
- Neuropathology Department, Great Ormond Street Hospital, London, UK
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Academic Medical Center, Amsterdam, The Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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25
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Nunes RH, Hsu CCT, Osborn AG. Presumptive diagnosis of multinodular vacuolating tumor: "more than meets the eye!". Neuroradiology 2017; 59:1067-1068. [PMID: 28887663 DOI: 10.1007/s00234-017-1916-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Renato Hoffmann Nunes
- Division of Neuroradiology, Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil. .,Division of Neuroradiology, Diagnosticos da America SA, São Paulo, Brazil.
| | | | - Anne G Osborn
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
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26
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Natural history of lesions with the MR imaging appearance of multinodular and vacuolating neuronal tumor. Neuroradiology 2017; 59:873-883. [DOI: 10.1007/s00234-017-1884-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/06/2017] [Indexed: 11/26/2022]
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27
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Badat N, Savatovsky J, Charbonneau F, Collin A, Lecler A. Multinodular vacuolating and neuronal tumor of the cerebrum. Neurology 2017; 89:304-305. [DOI: 10.1212/wnl.0000000000004123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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28
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Nunes RH, Hsu CC, da Rocha AJ, do Amaral LLF, Godoy LFS, Watkins TW, Marussi VH, Warmuth-Metz M, Alves HC, Goncalves FG, Kleinschmidt-DeMasters BK, Osborn AG. Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New "Leave Me Alone" Lesion with a Characteristic Imaging Pattern. AJNR Am J Neuroradiol 2017; 38:1899-1904. [PMID: 28705817 DOI: 10.3174/ajnr.a5281] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/03/2017] [Indexed: 11/07/2022]
Abstract
Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. We report 33 cases of presumed multinodular and vacuolating neuronal tumor of the cerebrum that exhibit a remarkably similar pattern of imaging findings consisting of a subcortical cluster of nodular lesions located on the inner surface of an otherwise normal-appearing cortex, principally within the deep cortical ribbon and superficial subcortical white matter, which is hyperintense on FLAIR. Only 4 of our cases are biopsy-proven because most were asymptomatic and incidentally discovered. The remaining were followed for a minimum of 24 months (mean, 3 years) without interval change. We demonstrate that these are benign, nonaggressive lesions that do not require biopsy in asymptomatic patients and behave more like a malformative process than a true neoplasm.
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Affiliation(s)
- R H Nunes
- From the Division of Neuroradiology (R.H.N., A.J.d.R., L.L.F.d.A., H.C.A.), Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil .,Division of Neuroradiology (R.H.N., A.J.d.R.), Diagnosticos da America SA, Sao Paulo, Brazil
| | - C C Hsu
- Department of Medical Imaging (C.C.H., T.W.W.), Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - A J da Rocha
- From the Division of Neuroradiology (R.H.N., A.J.d.R., L.L.F.d.A., H.C.A.), Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil.,Division of Neuroradiology (R.H.N., A.J.d.R.), Diagnosticos da America SA, Sao Paulo, Brazil
| | - L L F do Amaral
- From the Division of Neuroradiology (R.H.N., A.J.d.R., L.L.F.d.A., H.C.A.), Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil.,Division of Neuroradiology (L.L.F.d.A., V.H.M.), Medimagem, Hospital da Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
| | - L F S Godoy
- Department of Radiology (L.F.S.G.), Hospital Sirio Libanes, Sao Paulo, Brazil.,Department of Radiology (L.F.S.G.), Medical School, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T W Watkins
- Department of Medical Imaging (C.C.H., T.W.W.), Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - V H Marussi
- Division of Neuroradiology (L.L.F.d.A., V.H.M.), Medimagem, Hospital da Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
| | - M Warmuth-Metz
- Department of Neuroradiology (M.W.-M.), University Hospital Würzburg, Würzburg, Germany
| | - H C Alves
- From the Division of Neuroradiology (R.H.N., A.J.d.R., L.L.F.d.A., H.C.A.), Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | - F G Goncalves
- Department of Radiology (F.G.G.), Children's Hospital of Brasilia, Brasilia, Brazil
| | | | - A G Osborn
- Department of Radiology (A.G.O.), University of Utah, Salt Lake City, Utah
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29
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30
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Abstract
Rapid developments in molecular genetic technology and research have swiftly advanced our understanding of neuro-oncology. As a consequence, the WHO invited their expert panels to revise the current classification system of brain tumours and to introduce, for the first time, a molecular genetic approach for selected tumour entities, thus setting a new gold standard in histopathology. The revised 5th edition of the 'blue book' was released in May 2016 and will have a major impact in stratifying diagnosis and treatment. However, low-grade neuroepithelial tumours that present with early-onset focal epilepsy and are mostly seen in children and young adults (previously designated as long-term epilepsy-associated neuroepithelial tumours, LEAT) lack such innovative clinicopathological and molecular genetic tools. The Neuropathology Task Force of the International League against Epilepsy will critically discuss this issue, and will offer perspectives on how to decipher and validate clinically meaningful LEAT entities using the current WHO approach that integrates clinicopathological and genetic classification systems.
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31
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Yamaguchi M, Komori T, Nakata Y, Yagishita A, Morino M, Isozaki E. Multinodular and vacuolating neuronal tumor affecting amygdala and hippocampus: A quasi-tumor? Pathol Int 2015; 66:34-41. [DOI: 10.1111/pin.12366] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 11/02/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Maki Yamaguchi
- Department of Laboratory Medicine and Pathology (Neuropathology); Tokyo Metropolitan Neurological Hospital; Tokyo Japan
- Department of Diagnostic Pathology; Kyoto University Hospital; Kyoto Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology); Tokyo Metropolitan Neurological Hospital; Tokyo Japan
| | - Yasuhiro Nakata
- Department of Neuroradiology; Tokyo Metropolitan Neurological Hospital; Tokyo Japan
| | - Akira Yagishita
- Department of Neuroradiology; Tokyo Metropolitan Neurological Hospital; Tokyo Japan
| | - Michiharu Morino
- Department of Neurosurgery; Tokyo Metropolitan Neurological Hospital; Tokyo Japan
| | - Eiji Isozaki
- Department of Neurology; Tokyo Metropolitan Neurological Hospital; Tokyo Japan
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