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Li J, Li C, Zhang Q, Qiu C. Leukoencephalopathy with calcifications and cysts: A case report with literature review. Neurol Sci 2023:10.1007/s10072-023-06776-y. [PMID: 37004603 DOI: 10.1007/s10072-023-06776-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
Leukoencephalopathy with calcifications and cysts (LCC; OMIM #614561) is a rare disease and at present there are less than 100 cases reported worldwide. Mutations in the SNORD118 gene is now known to be the cause of LCC. We present a case who was heterozygous for the n.70G>A and n.6C>T sequence variants of the SNORD118 gene, variants which to date have not been described. Compared with the cases that we reviewed, our patient had the second longest time to diagnosis (age 56) from onset of symptoms 40 years prior. Moreover, his cousin's family has a high prevalence of epilepsy. This paper reviewed all published reports to date that had descriptive cases involving LCC as well as testing for the SNORD118 gene. Since 1996 only 85 patients have been described in 59 case reports. In this review, we summarize their clinical features, especially central nervous system symptoms, treatment, pathology, and gene testing results.
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Affiliation(s)
- Jingya Li
- Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, P. R. China
| | - Chun Li
- Department of Neurology, Anji Traditional Chinese Medical Hospital, 299 Shengli West Road,, Anji Huzhou, Zhejiang Province, P. R. China
| | - Qing Zhang
- Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, P. R. China
| | - Chao Qiu
- Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, P. R. China.
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Osman O, Labrune P, Reiner P, Sarov M, Nasser G, Riant F, Tournier-lasserve E, Chabriat H, Denier C. Leukoencephalopathy with calcifications and cysts (LCC): 5 cases and literature review. Rev Neurol (Paris) 2020; 176:170-179. [DOI: 10.1016/j.neurol.2019.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 11/25/2022]
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Ma Y, Zhang X, Cheng C, Xu Q, Di H, Zhao J, Huang D, Yu S. Leukoencephalopathy with calcifications and cysts: A case report. Medicine (Baltimore) 2017; 96:e7597. [PMID: 28723803 PMCID: PMC5521943 DOI: 10.1097/md.0000000000007597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Leukoencephalopathy with calcifications and cysts (LCC) is an uncommon entity characterized by edematous leukoencephalopathy, cerebral calcifications, and parenchymal cysts. Due to its rarity, the clinical, radiological, and histopathological features have yet to be well elucidated. PATIENT CONCERNS The first case is a 35-year-old female who was asymptomatic. A giant intracranial cyst was incidentally detected radiologically, and it was slowly growing in the recent 10 years. The second case is a 20-year-old female who presented with a 1-month history of headache. Brain computed tomography showed multiple asymmetric calcifications in the bilateral basal ganglia and white matter. Magnetic resonance imaging revealed a cyst in the right parietal lobe. DIAGNOSES They were diagnosed with LCC. INTERVENTIONS AND OUTCOMES The first patient underwent surgical resection of the intracranial cyst, and the second patient received a stereotactic biopsy. The patients performed well postoperatively. LESSONS LCC can be found at any age. A young age seems to be associated with severer symptoms. The clinical manifestations can be variable and aggressive. The potential pathogenic basis still needs further research.
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Affiliation(s)
- Yubao Ma
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Xingwen Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Chen Cheng
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Quangang Xu
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Hai Di
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Jiao Zhao
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Dehui Huang
- Department of Neurology, Chinese PLA General Hospital, Beijing
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing
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Tamura R, Ohira T, Emoto K, Fujiwara H, Horikoshi T, Yoshida K. Leukoencephalopathy, cerebral calcifications, and cysts: A clinical case involving a long-term follow-up and literature review. J Neurol Sci 2016; 373:60-65. [PMID: 28131229 DOI: 10.1016/j.jns.2016.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/24/2016] [Accepted: 12/09/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Leukoencephalopathy, cerebral calcifications, and cysts (LCC) is a rare disease that was first reported by Labrune in 1996. A case of adult-onset LCC was successfully followed up for a long period. CASE PRESENTATION A 30-year-old female presented with visual field disturbance and seizure on several occasions. Radiographic images revealed multiple supratentorial cysts and calcifications in the bilateral nucleus basalis and cerebella. Aspiration, Ommaya reservoir placement, and nodule removal were performed for the responsible cysts, and the patient had a good postoperative course. DISCUSSION A tiny, strongly enhanced nodule was identified before cyst formation on her radiographic images. Thus, cyst growth may be related to nodule microbleeding. According to our review, if the responsible cyst is located on the noneloquent area, surgical removal of the cyst should be considered. However, if the responsible cyst is located on the eloquent area, the nodule should be first removed because nodules can bleed and enlarge cysts. CONCLUSION Careful follow-up is needed, especially for cysts with a strongly enhanced nodule.
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Affiliation(s)
- Ryota Tamura
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Takayuki Ohira
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Katsura Emoto
- Department of Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hirokazu Fujiwara
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomo Horikoshi
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Leukoencephalopathy with cerebral calcification and cysts: Cases report and literature review. J Neurol Sci 2016; 370:173-179. [PMID: 27772754 DOI: 10.1016/j.jns.2016.09.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/22/2016] [Accepted: 09/23/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND Leukoencephalopathy with calcifications and cysts (LCC) is a rare disease in which parenchymal cysts and calcifications within a widespread leukoencephalopathy can cause a broad spectrum of neurological symptoms. We present cases with adult LCC and discuss previously described entities in relevant literature. CASE PRESENTATION Two cases of adult-onset LCC confirmed by clinical presentations, typical neuroimaging and neuropathological findings are reported. LITERATURE REVIEW A detailed search of all relevant reports published in the English language between 1996 and 2015 via PubMed (http://www.ncbi.nlm.nih.gov/pubmed) was performed, with "Leukoencephalopathy", "cerebral calcifications" and "cysts" as keywords. Including the current cases, we summarized the clinical presentations, neuroimaging features, biopsy features, and genetic features of 38 LCC patients. CONCLUSION Our findings suggested that LCC could be diagnosed by clinical presentations, neuroimaging and gene detection, and biopsy might not be necessary. Therefore, we propose a diagnostic flow chart for neuroimaging in leukoencephalopathy, cerebral calcifications and cysts.
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Stephani C, Pfeifenbring S, Mohr A, Stadelmann C. Late-onset leukoencephalopathy with cerebral calcifications and cysts: case report and review of the literature. BMC Neurol 2016; 16:19. [PMID: 26852234 PMCID: PMC4744425 DOI: 10.1186/s12883-016-0543-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background Leukoencephalopathy with calcifications and cysts (LCC or Labrune disease) is a relatively recently defined and exceptionally rare disease in which parenchymal cysts and calcifications within a widespread leukoencephalopathy can cause a broad spectrum of neurological symptoms. The cause of the disease is unknown. Manifestation is usually in childhood or adolescence, while onset in adulthood has been described in 19 cases. Case presentation Here we report a case of an adult-onset LCC of a Caucasian woman who became symptomatic at age 70 as confirmed by typical neuroimaging and neuropathological findings. After resection of left mesioparietal space-occupying cystic brain tissue the patient has so far remained clinically stable during one year of follow-up with a continuous treatment with glucocorticosteroids. Conclusion To our knowledge this report of a patient who became symptomatic at age 70 represents the oldest age-at-onset case of LCC described so far.
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Affiliation(s)
- C Stephani
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - S Pfeifenbring
- Department of Neuropathology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - A Mohr
- Department of Neuroradiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - C Stadelmann
- Department of Neuropathology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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Li Z, Han K, Yao W, Wei W, Li Y, Lan X. Adult-Onset Leukoencephalopathy with Calcifications and Cysts: Focusing on Hemorrhagic Propensity and Cysts Development. World Neurosurg 2015; 85:366.e9-13. [PMID: 26407930 DOI: 10.1016/j.wneu.2015.09.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/07/2015] [Accepted: 09/08/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND An uncommon disorder, adult-onset leukoencephalopathy with calcifications and cysts (ALCC) has been recognized clinically for approximately a decade. Its typical radiologic signs and pathologic characteristics have been investigated thoroughly and described fully in a series of cases. However, little attention has focused on the propensity of hemorrhage in this entity, and the etiology of cyst occurrence in ALLC remains uncertain. To the best of our knowledge, there is a lack of relevant articles addressing the relationship between hemorrhage and cyst development in ALCC. CASE DESCRIPTION A 30-year-old woman presented with headache, diminishing eyesight, and face numbness over the course of 16 months. Repeat radiologic examination showed the formation of a new cyst and the enlargement of former cyst after hemorrhage. She was diagnosed formerly with ALCC with the triad of leukoencephalopathy, calcifications, and cyst in imaging. Staging gross total resections of cyst were achieved with neurologic improvement postoperatively. Histologic examination revealed angiomatous vessels, Rosenthal fiber formation, microcalcification, and deposits of hemosiderin, and ALCC was confirmed pathologically. CONCLUSIONS After analyzing the clinical data about the hemorrhage and cysts in our case and all 15 reported ALCC cases in the literature, we conclude that intermittent hemorrhage and cysts development are 2 outstanding features for ALCC and that hemorrhage is a probable mechanism for the formation and expansion of cyst.
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Affiliation(s)
- Zhaojian Li
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province, China.
| | - Kun Han
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province, China
| | - Weicheng Yao
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province, China
| | - Wei Wei
- Department of Medicine, People's Hospital of Shinan District, Qingdao City, Shandong Province, China
| | - Yujun Li
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province, China
| | - Xiaolei Lan
- Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province, China
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Banks GP, Weiss SA, Pisapia D, Willey JZ. A case of late-onset leukoencephalopathy, calcifications, and cysts presenting with intracerebral hemorrhage resembling a neoplasm. Cerebrovasc Dis 2013; 35:396-7. [PMID: 23635489 DOI: 10.1159/000348312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Garrett P Banks
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
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