Multinodular and vacuolating neuronal tumour of the cerebrum: a rare neuroimaging incidentaloma or a potentially treatable cause of focal epilepsy?

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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Collision tumor: Multinodular and vacuolating neuronal tumor with isocitrate dehydrogenase‐mutant diffuse astrocytoma

Kumar,

Perez,

Young

et al. 2024

Neuropathology

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Herein, we report a case of a collision tumor involving a multinodular and vacuolating neuronal tumor (MVNT) and a diffuse astrocytoma. A collision tumor between these two entities has not previously been reported. The patient is a 35‐year‐old woman who presented with new‐onset hearing loss and ringing in her right ear. Magnetic resonance imaging identified a non‐enhancing mass involving the gray matter and subcortical white matter of the left middle frontal gyrus. Additionally, tiny clustered nodules were noted along the underlying subcortical ribbon and superficial subcortical white matter of the left superior frontal gyrus. The patient underwent a left frontal craniotomy and complete resection of the mass. Histologic examination of the resected specimen demonstrated a collision tumor consisting of a diffuse astrocytoma (isocitrate dehydrogenase [IDH] mutant, central nervous system [CNS] World Health Organization [WHO] grade 2) and an MVNT, with the latter demonstrating characteristic morphologic and immunohistochemical features.

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Multinodular and vacuolating neuronal tumour of the cerebrum: a rare neuroimaging incidentaloma or a potentially treatable cause of focal epilepsy?

Cited by 3 publications

References 20 publications

Non-dominant, Lesional Neocortical Temporal Lobe Epilepsy

Non-dominant, Lesional Neocortical Temporal Lobe Epilepsy

Advanced multiparametric magnetic resonance imaging of multinodular and vacuolating neuronal tumor

Collision tumor: Multinodular and vacuolating neuronal tumor with isocitrate dehydrogenase‐mutant diffuse astrocytoma

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