The rosette-forming glioneuronal tumor mimicked cerebral cysticercosis: a case report

Abstract

Introduction Rosette-forming glioneuronal tumor (RGNT) is a rare variety of slow growing mixed glioneuronal tumor involving primarily fourth ventricular region. This is a comprehensive analysis of a 22-year-old woman with RGNT composed of mainly cystic components. In addition, the case showed multiple lesions located in brain parenchyma which mimicked cerebral cysticercosis. Here, we analyzed this case and listed some characteristics of RGNTs in reported literature which occurring in atypical locations for further understanding it. Case report A 22-year-old woman presented with a history of transient dizziness, nausea, and vomiting. Magnetic resonance imaging (MRI) showed multiple cystic lesions in brain parenchyma and then the patient was diagnosed with cerebral cysticercosis possibility. Empirical anti-infective therapy in addition to a follow-up post 2 weeks of MRI examination showed the lesions unchanged. Finally, a biopsy of the right cerebellar hemisphere lesions verified RGNT. Conclusion RGNT is an uncommon tumor classified as grade I glioma by World Health Organization (WHO) with slightly longer course. The imaging findings of RGNT are not specific especially in atypical areas. RGNT is rare, but we should also consider the possibility in diagnosis and differential diagnosis.

Diffusely invasive supratentorial rosette-forming glioneuronal tumor: illustrative case

“…A total of 49 cases of supratentorial RGNT were included among 38 studies (Table 1). 3,4, Our analysis suggests that hydrocephalus is a predominant finding in patients with a supratentorial presentation (63% of 49 cases), with a higher rate than reported in infratentorial cases. Patients typically present with headaches and visual changes, nausea or vomiting, gait disturbances, seizures, vertigo, weakness, paresthesias, and dysmetria.…”

“…Although rarely seen in RGNT, intratumoral hemorrhage has been reported and may be distinguishing from other pathologies with similar radiological features, particularly cysticercosis. 3 …”

“…Radiological identification of this rare lesion can be challenging, with its features similar to other more well-known neurological diseases, such as neurocysticercosis or dysembryoplastic neuroepithelial tumor (DNET). 2 , 3 Patients often present with vague symptoms of headaches secondary to hydrocephalus, visual changes, or seizures. In extremely rare instances, diffuse involvement of the supratentorial region is encountered, thereby creating significant challenges in diagnosis, surgical intervention, adjuvant therapy, and determination of prognosis.…”

The 2021 WHO Classification for Gliomas and Implications on Imaging Diagnosis: Part 3—Summary of Imaging Findings on Glioneuronal and Neuronal Tumors

“…There is no generally diffusion restriction on ADC map 64,66,67 . A case report showed no rCBV increase 68 . Imaging spectrums of RGNT in two different patients are shown in Fig.…”

“…64,66,67 A case report showed no rCBV increase. 68 Imaging spectrums of RGNT in two different patients are shown in Fig. 11 [Correction added after first online publication on 19 October 2023.…”