Dysembryoplastic neuroepithelial tumor originally diagnosed as astrocytoma and oligodendroglioma

Dozza, Diego Cassol; Rodrigues, Flávio Henrique Guimarães; Chimelli, Leila

doi:10.1590/s0004-282x2012000900012

Cited by 6 publications

(18 citation statements)

References 16 publications

(18 reference statements)

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“…A diagnosis of DNT should also consider various other tumors with neuronal and glial components that are included in a heterogeneous group of mixed neuronal‐glial tumors of the CNS . Occasionally, unusual compound tumors have been reported, which show features characteristic of DNT and pleomorphic xanthoastrocytoma or ganglioglioma .…”

Section: Discussionmentioning

confidence: 99%

A peculiar histopathological form of dysembryoplastic neuroepithelial tumor with separated pilocytic astrocytoma and rosette-forming glioneuronal tumor components

et al. 2014

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Dysembryoplastic neuroepithelial tumors (DNTs) mostly display typical clinical, neuroimaging and histopathological features, but sometimes they reveal heterogeneous or non-specific morphology, which results in diagnostic dilemmas. We present a case of a young adult with longstanding, intractable epilepsy associated with a multinodular cystic lesion in the temporal lobe. The lesion consisted of morphologically different components. In particular, a few cortical nodules displayed a specific glioneuronal element with floating neurons typically found in DNT. Two large, well-circumscribed nodules were entirely composed of biphasic, piloid, astroglial patterns that corresponded strictly to a pilocytic astrocytoma. The well-defined areas, which contained numerous distinct neurocytic-like rosettes, were identical with rosette-forming glioneuronal tumors (RGNTs). This type of neurocytic rosette was widespread within the surrounding piloid background. Some solid nodules exhibited increased cellularity, oligodendroglioma-like elements and a focal ribbon cell arrangement. The lesion was associated with advanced reactive gliosis and foci of dysplastic changes in the adjacent cortex. The clinico-radiological and main histopathological features were consistent with a diagnosis of a complex variant of DNT composed of pilocytic and rosette-forming glioneuronal components. Although both piloid tissue and rosette-like formations have been occasionally mentioned in DNT lesions, the present case of DNT was unique in its well-circumscribed, separate pilocytic and RGNT nodules. We concluded that it represented an unusual, mixed pilocytic/RGNT variant of DNT.

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“…Uncertainty is not only restricted to histological classification but also to tumour grading (Daumas‐Duport et al ., ; Campos et al ., ; Dozza et al ., ; Chassoux et al ., ). Some clinicians may consider discrepancies in the classification of benign brain tumours as an academic issue.…”

Section: Of More Concern ‐ Different Grading Of One and The Same Leatmentioning

confidence: 97%

Epilepsy-associated tumours: what epileptologists should know about neuropathology, terminology, and classification systems

Holthausen

Blümcke²

2016

Epileptic Disorders

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Brain tumours are an ever‐challenging issue in neurology and related medical disciplines. This applies in particular to brain tumours associated with childhood‐onset epilepsies, in which seizures are the presenting and only neurological symptom, as our current understanding of the biology and clinical behaviour of an individual tumour is far from being evidence‐based. Prospective and randomized clinical trials are lacking in the field of epilepsy‐associated tumours and a review of the current literature evokes more questions than provides answers. In this review, current areas of controversy in neuropathology, as well as terminology and classification, are discussed from an epileptologist's perspective. An illustrative case report exemplifies this controversy to further promote interdisciplinary discussion and novel research avenues towards comprehensive patient management in the near future.

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“…Analysis of 4.454 tumours obtained from adults and children, published in eight single‐centre epilepsy surgery series, revealed huge differences in geographical prevalence (Table ), ranging from 4% to 44% for glioma, 7% to 50% for GG and 13% to 80% for DNT . Uncertainty is not restricted to the histological classification but also observed in tumour grading . LEAT carry only remote risk for malignant progression, and the WHO classification did not define atypical variants for GG and DNT.…”

Section: Introductionmentioning

confidence: 99%

Review: Challenges in the histopathological classification of ganglioglioma and DNT: microscopic agreement studies and a preliminary genotype‐phenotype analysis

Blümcke

Coras

Wefers

et al. 2018

Neuropathol Appl Neurobiol

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the yield of histopathology agreement in four consecutive trials. To this end, the Task Force applied the WHO 2016 strategy of integrating phenotype analysis with molecular-genetic data obtained from panel sequencing and 450k methylation arrays. This strategy was helpful to distinguish DNT from GG variants in all cases. The Task Force recommends, therefore, to further develop diagnostic panels for the integration of phenotype-genotype analysis in order to reliably classify the spectrum of LEAT, carefully characterize clinically meaningful entities and make better use of published literature. NAN 2019; 45: 95-107 96 I. Bl€ umcke et al.

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“…Although the tumor was initially diagnosed as a pilocytic astrocytoma or pleomorphic xanthoastrocytoma based on the manifestation on the neuroimaging, microscopic pathology revealed the tumor to be a typical DNT. From a review of the previous literature, similar presentations have been identified using enhanced imaging in a number of cases (11,12,22,30,31). …”

Section: Discussionmentioning

confidence: 90%

“…In the majority of patients in whom the recurrent tumor has progressed into a WHO Grade II tumor, a favorable prognosis may be achieved through a GTR of the recurrent lesion. The case of a patient who remained tumor-free five years following the second surgery has also been reported (10,17,22,23). In the present case, the patient underwent focal radiotherapy and the tumor did not recur within a follow-up period of 11 months.…”

Section: Discussionmentioning

confidence: 93%

Recurrence and histological evolution of dysembryoplastic neuroepithelial tumor: A case report and review of the literature

et al. 2013

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Studies of recurrent dysembryoplastic neuroepithelial tumors (DNTs) are distinctly rare. The present study reports the case of a 15-year-old female with a temporal lobe DNT, which recurred and transformed into an astrocytoma (WHO grade II) five years after an initial gross total resection (GTR). Furthermore, all the previous studies on recurrent DNT are reviewed. Although the majority of DNT cases demonstrate benign behavior, recurrent DNTs have been observed following a GTR of the tumor. Patients do not appear to benefit from post-operative adjuvant therapy, and inappropriate radiotherapy or chemotherapy may result in tumor recurrence or malignant transformation. The prognosis is favorable if a GTR of the recurrent tumor is achieved. The use of regular imaging examinations and the maintenance of a long-term follow-up is of importance following a tumor resection.

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Dysembryoplastic neuroepithelial tumor originally diagnosed as astrocytoma and oligodendroglioma

Cited by 6 publications

References 16 publications

A peculiar histopathological form of dysembryoplastic neuroepithelial tumor with separated pilocytic astrocytoma and rosette-forming glioneuronal tumor components

Epilepsy-associated tumours: what epileptologists should know about neuropathology, terminology, and classification systems

Review: Challenges in the histopathological classification of ganglioglioma and DNT: microscopic agreement studies and a preliminary genotype‐phenotype analysis

Recurrence and histological evolution of dysembryoplastic neuroepithelial tumor: A case report and review of the literature

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