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Hao Z, Zhanghuang C, Zhang K, Hang Y, Ji F, Yan B, Tang H. Posterior urethral hamartoma with hypospadias in a child: a case report and literature review. Front Pediatr 2023; 11:1195900. [PMID: 37675396 PMCID: PMC10477777 DOI: 10.3389/fped.2023.1195900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Background Hamartoma is a mass formed by the proliferation and disorder of two or more kinds of cells inherent in normal organs or anatomical parts, which can occur in any part of the body. The most common hamartoma are kidney hamartoma, spleen hamartoma, liver hamartoma, and lung hamartoma. Urethral hamartoma is extremely rare in clinical practice. Case report Combined with literature review, the diagnosis and treatment process of a child with posterior urethral hamartoma and hypospadias in our hospital were analyzed. The patient was cured after surgical treatment, the lesion was completely removed, the appearance was satisfactory, and there was no recurrence, urethral stricture, urethral fistula, and other complications. The pathological results of this case support the histological diagnosis of hamartoma, which provides reference for the clinical diagnosis and treatment of congenital malformation and tumor of urogenital in children. Conclusion When a child has posterior urethral hamartoma, the symptoms may not be very typical, and it is often combined with urethral malformation. Therefore, it is necessary to perform careful physical examination combined with pathological examination to be able to make an accurate diagnosis. Under normal circumstances, the prognosis of urethral hamartoma is good. However, more cases are needed to be observed for verification, and a long-term effective follow-up after surgery is needed.
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Affiliation(s)
- Zipeng Hao
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Chenghao Zhanghuang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
- Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Kunming, China
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Kun Zhang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Yu Hang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Fengming Ji
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Bing Yan
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
| | - Haoyu Tang
- Department of Urology, Kunming Children’s Hospital (Children’s Hospital Affiliated to Kunming Medical University), Kunming, China
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Munjal H, Mistry D, Almast J, Ellika S. Bilateral oligodendroglial hamartomas: A rare cause of drug-resistant epilepsy in a pediatric patient. J Clin Imaging Sci 2022; 12:24. [PMID: 35673591 PMCID: PMC9168290 DOI: 10.25259/jcis_197_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/28/2022] [Indexed: 11/04/2022] Open
Abstract
Intractable or drug-resistant seizures in pediatric patients are often secondary to cortical malformations, hamartomas, or mass lesions. Various subtypes of intracerebral hamartomas, associated with seizure disorders, have been described. In this report, we describe a subtype of intracerebral hamartoma associated with intractable epilepsy in a 10-year-old patient. Initial MR imaging demonstrated a mildly expansile, T2/FLAIR hyperintense, T1 isointense, nonenhancing lesion with blurring of the gray-white junction in the left amygdala. Surgical resection was performed, and pathology confirmed oligodendroglial hamartoma. Patient’s seizures recurred after a two-year interval with imaging demonstrating a similar lesion in the right amygdala which in retrospect was also seen on multiple imaging studies. This case report demonstrates the importance of recognizing oligodendroglial hamartomas as a cause of intractable seizures given the imaging findings, distinguishing it from ganglioglioma, dysembryoplastic neuroepithelial tumor, and oligodendroglioma, and the importance of closely looking/searching for contralateral lesions, which has important therapeutic and prognostic implications.
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Affiliation(s)
- Havisha Munjal
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States,
| | - Devanshi Mistry
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States,
| | - Jeevak Almast
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States,
| | - Shehanaz Ellika
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, United States,
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Gu J, Wang Y, Yu J. Cerebral astroblastoma with oligodendroglial-like cells: A case report. Medicine (Baltimore) 2021; 100:e27570. [PMID: 34713831 PMCID: PMC8556017 DOI: 10.1097/md.0000000000027570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/07/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Astroblastoma is a rare tumor of the central nervous system with uncertain biological behavior and origin. Its histopathological features have been well established, while, to our knowledge, astroblastoma with oligodendroglial-like cells have not been reported. PATIENT CONCERNS A 15-year-old girl presented with nausea, vomiting, headache, and visual disturbance. DIAGNOSIS Magnetic resonance imaging revealed a large neoplasm in the left temporal. Histologically, the tumor showed solid and pseudopapillary structure. Immunohistochemical staining showed that the tumor cells were positive for glial fibrillary acidic protein and vimentin. The oligodendroglial-like cells were positive for glial fibrillary acidic protein, vimentin, and oligodendrocyte transcription factor 2. The antigen KI67 labeling index was about 4%. Sequencing for isocitrate dehydrogenase (IDH) 1 codon 132 and IDH2 codon 172 gene mutations showed negative results. Furthermore, fluorescent analysis revealed neither 1p nor 19q deletion in the lesion. Based on these findings, the girl was finally diagnosed as astroblastoma. INTERVENTIONS A craniotomy with total excision of the tumor was performed. OUTCOMES The follow-up time was 1 year, no evidence of disease recurrence was found in magnetic resonance imaging. LESSONS Cerebral astroblastoma with oligodendroglial-like cells is a clinically rare tumor of central nervous system. Clear distinction and diagnosis are critical.
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Affiliation(s)
- Jian Gu
- Department of Pathology, the First Affiliated Hospital of China Medical University,Shenyang, China
- Department of Pathology, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Yihua Wang
- Department of Pathology, the First Affiliated Hospital of China Medical University,Shenyang, China
- Department of Pathology, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Juanhan Yu
- Department of Pathology, the First Affiliated Hospital of China Medical University,Shenyang, China
- Department of Pathology, College of Basic Medical Sciences, China Medical University, Shenyang, China
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Epileptic Patient with Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia and Epilepsy (MOGHE): A Case Report and Review of the Literature. Case Rep Neurol Med 2019; 2019:9130780. [PMID: 31281692 PMCID: PMC6590559 DOI: 10.1155/2019/9130780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/08/2019] [Accepted: 05/12/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction There is an emerging interest in the literature about MOGHE (Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia and Epilepsy). We report the case of an epileptic patient with MOGHE. Case Report A 33-year-old male patient was suffering from refractory focal epilepsy since adolescence. MRI demonstrated increased T2/FLAIR signal intensity of right frontal lobe. Presurgical evaluation led to definition of epileptogenic network in a specific area of right frontal lobe. The resected specimen revealed MOGHE. Discussion. MOGHE appears to be a brain entity which shares some unique histopathological features. Review of the literature is in accordance with our patient's findings. The major neuropathological finding consists of areas with blurred gray-white matter boundaries due to heterotopic neurons in white matter and increased numbers of subcortical oligodendroglial cells with increased proliferation. MR abnormalities are present in T2/FLAIR sequences. It concerns patients with refractory frontal lobe epilepsy and appears to associate with unfavourable postsurgical outcome in seizure control. Conclusion More cases are needed in order to establish more data about this distinct entity in frontal lobe epilepsy. This could be valuable knowledge to patients and doctors concerning expectations or management of undesirable outcome in frontal lobe epilepsy surgery.
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Mata-Mbemba D, Iimura Y, Hazrati LN, Ochi A, Otsubo H, Snead OC, Rutka J, Widjaja E. MRI, Magnetoencephalography, and Surgical Outcome of Oligodendrocytosis versus Focal Cortical Dysplasia Type I. AJNR Am J Neuroradiol 2018; 39:2371-2377. [PMID: 30442696 DOI: 10.3174/ajnr.a5877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/19/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND PURPOSE Abnormalities of oligodendrocytes have been reported in surgical specimens of patients with medically intractable epilepsy. The aim of this study was to compare the MR imaging, magnetoencephalography, and surgical outcome of children with oligodendrocytosis relative to focal cortical dysplasia I. MATERIALS AND METHODS Oligodendrocytosis included oligodendroglial hyperplasia, oligodendrogliosis, and oligodendroglial-like cells in the white matter, gray matter, or both from children with medically intractable epilepsy. Focal cortical dysplasia I included radial and tangential cortical dyslamination. The MR imaging, magnetoencephalography, type of operation, location, and seizure outcome of oligodendrocytosis, focal cortical dysplasia I, and oligodendrocytosis + focal cortical dysplasia I were compared. RESULTS Eighteen subjects (39.1%) had oligodendrocytosis, 21 (45.7%) had focal cortical dysplasia I, and 7 (15.2%) had oligodendrocytosis + focal cortical dysplasia I. There were no significant differences in the type of seizures, focal or nonfocal epileptiform discharges, magnetoencephalography, and MR imaging features, including high T1 signal in the cortex, high T2/FLAIR signal in the cortex or subcortical white matter, increased cortical thickness, blurring of the gray-white junction, or abnormal sulcation and gyration among those with oligodendrocytosis, focal cortical dysplasia I, or oligodendrocytosis + focal cortical dysplasia I (P > .01). There were no significant differences in the extent of resection (unilobar versus multilobar versus hemispherectomy), location of the operation (temporal versus extratemporal versus both), or seizure-free outcome of oligodendrocytosis, focal cortical dysplasia I, and oligodendrocytosis + focal cortical dysplasia I (P > .05). CONCLUSIONS Oligodendrocytosis shared MR imaging and magnetoencephalography features with focal cortical dysplasia I, and multilobar resection was frequently required to achieve seizure freedom. In 15% of cases, concurrent oligodendrocytosis and focal cortical dysplasia I were identified. The findings suggest that oligodendrocytosis may represent a mild spectrum of malformations of cortical development.
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Affiliation(s)
- D Mata-Mbemba
- From the Department of Diagnostic Imaging (D.M.-M., E.W.)
| | - Y Iimura
- Division of Neurology (Y.I., A.O., H.O., O.C.S., E.W.)
| | | | - A Ochi
- Division of Neurology (Y.I., A.O., H.O., O.C.S., E.W.)
| | - H Otsubo
- Division of Neurology (Y.I., A.O., H.O., O.C.S., E.W.)
| | - O C Snead
- Division of Neurology (Y.I., A.O., H.O., O.C.S., E.W.)
| | - J Rutka
- Neurosurgery (J.R.), The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - E Widjaja
- From the Department of Diagnostic Imaging (D.M.-M., E.W.) .,Division of Neurology (Y.I., A.O., H.O., O.C.S., E.W.)
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Sone D, Ikemura M, Saito Y, Taniguchi G, Kunii N. Marked accumulation of oligodendroglia-like cells in temporal lobe epilepsy with amygdala enlargement and hippocampal sclerosis. Neuropathology 2017; 38:154-158. [PMID: 28841245 DOI: 10.1111/neup.12410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022]
Abstract
Although an increasing number of cases of temporal lobe epilepsy (TLE) with ipsilateral amygdala enlargement (AE) have been reported, there are few pathological reports, and no clear consensus has been established. Oligodendroglia or oligodendroglia-like cells (OLCs) have recently attracted attention in epilepsy studies. Here, we report the clinical and pathological findings of a 40-year-old male TLE patient with AE and hippocampal sclerosis, in whom histopathological study demonstrated remarkable clustering of OLCs around the uncus. The patient began to have refractory seizures at the age of 14, and preoperative MRI revealed left amygdala enlargement and left hippocampal atrophy. Other examinations were consistent with left mesial temporal epileptogenicity. He underwent surgical resection and achieved seizure freedom. Histopathological study of the amygdala showed swollen neurons with relatively large bodies and thick neurites, accompanied by vacuolar degeneration in the background. Additionally, there were marked clusters of OLCs with round nuclei and densely stained chromatin around the uncus. The OLCs were Olig2-positive. In the hippocampus, severe cell loss in CA1 and granule cell dispersion in the dentate gyrus were found. These findings may provide some insights for further pathological investigations of TLE with non-neoplastic AE.
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Affiliation(s)
- Daichi Sone
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Saito
- Department of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Go Taniguchi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoto Kunii
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
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Schurr J, Coras R, Rössler K, Pieper T, Kudernatsch M, Holthausen H, Winkler P, Woermann F, Bien CG, Polster T, Schulz R, Kalbhenn T, Urbach H, Becker A, Grunwald T, Huppertz HJ, Gil-Nagel A, Toledano R, Feucht M, Mühlebner A, Czech T, Blümcke I. Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia in Frontal Lobe Epilepsy: A New Clinico-Pathological Entity. Brain Pathol 2016; 27:26-35. [PMID: 26748554 DOI: 10.1111/bpa.12347] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/21/2015] [Indexed: 01/06/2023] Open
Abstract
The histopathological spectrum of human epileptogenic brain lesions is widespread including common and rare variants of cortical malformations. However, 2-26% of epilepsy surgery specimens are histopathologically classified as nonlesional. We hypothesized that these specimens include also new diagnostic entities, in particular when presurgical magnetic resonance imaging (MRI) can identify abnormal signal intensities within the anatomical region of seizure onset. In our series of 1381 en bloc resected epilepsy surgery brain specimens, 52 cases could not be histopathologically classified and were considered nonlesional (3.7%). An increase of Olig2-, and PDGFR-alpha-immunoreactive oligodendroglia was observed in white matter and deep cortical layers in 22 of these patients (42%). Increased proliferation activity as well as heterotopic neurons in white matter were additional histopathological hallmarks. All patients suffered from frontal lobe epilepsy (FLE) with a median age of epilepsy onset at 4 years and 16 years at epilepsy surgery. Presurgical MRI suggested focal cortical dysplasia (FCD) in all patients. We suggest to classify this characteristic histopathology pattern as "mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE)." Further insights into pathomechanisms of MOGHE may help to bridge the diagnostic gap in children and young adults with difficult-to-treat FLE.
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Affiliation(s)
- Johannes Schurr
- Department of Neuropathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Tom Pieper
- Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
| | - Manfred Kudernatsch
- Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
| | - Hans Holthausen
- Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
| | - Peter Winkler
- Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
| | | | | | - Tilman Polster
- Epilepsy Center Bethel, Hospital Mara, Bielefeld, Germany
| | | | - Thilo Kalbhenn
- Department of Neurosurgery, Evangelisches Krankenhaus Bielefeld, Kantensiek 11, 33617 Bielefeld, Germany
| | - Horst Urbach
- Department of Radiology, University Hospital Bonn, 53127 Bonn, Germany.,Department of Radiology, University Hospital Freiburg, Freiburg, Germany
| | - Albert Becker
- Department of Neuropathology, University Hospital Bonn, 53127 Bonn, Germany
| | | | | | - Antonio Gil-Nagel
- Servicio de Neurología, Hospital Ruber International, C/La Masó n 38, 28034 Madrid, Spain
| | - Rafael Toledano
- Servicio de Neurología, Hospital Ruber International, C/La Masó n 38, 28034 Madrid, Spain
| | - Martha Feucht
- Department of Pediatrics, Medical University Vienna, 1090 Vienna, Austria
| | - Angelika Mühlebner
- Department of Pediatrics, Medical University Vienna, 1090 Vienna, Austria.,Institute of Neurology, Medical University Vienna, 1090 Vienna, Austria
| | - Thomas Czech
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria
| | - Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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Sebastianelli M, Mandara M, Pavone S, Canal S, Bernardini M. Thalamic astrocytic hamartoma and associated meningoangiomatosis in a German shepherd dog. Res Vet Sci 2013; 94:644-7. [DOI: 10.1016/j.rvsc.2012.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/09/2012] [Accepted: 11/17/2012] [Indexed: 11/24/2022]
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Multifocal presentation of medulloblastoma in adulthood. J Neurooncol 2011; 107:233-7. [DOI: 10.1007/s11060-011-0746-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 10/24/2011] [Indexed: 11/26/2022]
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