Recurrence of Dysembryoplastic Neuroepithelial Tumor following Resection
Department of Neurosurgery, University of Michigan, Ann Arbor, Mich. 48109-0338, USA.Pediatric Neurosurgery (Impact Factor: 0.33). 02/2008; 44(4):333-6. DOI: 10.1159/000138372
Dysembryoplastic neuroepithelial tumor (DNT) is an increasingly recognized surgically curable tumor that characteristically presents with seizures in children. We report a case of a patient who underwent resection of a histologically proven DNT at 6 years of age. The resection was thought to be total at the time of surgery, and this impression was confirmed on postoperative imaging. Following the initial resection, the patient underwent surveillance imaging at regular intervals. Six years following the initial surgery, surveillance imaging demonstrated an enlarging area of signal abnormality at the site of the prior resection. The patient underwent a second resection with pathological confirmation of DNT recurrence. Although recurrence of DNT following resection is rare, this case suggests that surveillance imaging may have a role in patients with DNT, even following resections that are thought to be complete.
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ABSTRACT: Gangliogliomas and gangliocytomas belong to a family of rare, slow-growing, neuronal tumors. Courville fi rst introduced the term “ganglioglioma” in 1930 to describe the mixed neuronal and glial elements typically seen in this tumor (Courville 1930). Although there is a pathologic difference between ganglioglioma and gangliocytoma, the natural history and biology of these two subtypes appear to be the same.
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ABSTRACT: Dysembryoplastic neuroepithelial tumour (DNT) is a benign lesion of the cerebral hemispheres usually presenting minimal biological activity after surgical excision. We report an unusual case of a 7-year-old girl with a temporal lobe DNT, which recurred four years after subtotal resection of the tumour. In the recurrent lesion we identified pilocytic astrocytoma (PA) as a predominant component of the tumour. Small pieces of the removed tissues also disclosed remnants of DNT. Clinical presentation of the primary tumour consisted of partial simple seizures, while the recurrent tumour manifested with headache and vomiting. Likewise, the radiological appearance of both tumours was different. We conclude that patients with incompletely removed DNT may suffer local recurrence of that tumour. In rare cases development of a secondary, histologically different neoplasm may also occur.
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