Multinodular and vacuolating brain tumors; what the radiologist needs to know

Congress:

ECR 2020

Poster Number:

C-00330

Type:

Educational Exhibit

Keywords:

Neuro, Head and neck, MR, Diagnostic procedure, Neoplasia, Not applicable, Performed at one institution

Authors:

S. Osorio Aira, M. Rodriguez Velasco, M. Sanchez Ronco, R. Petruzzella Lacave, I. Sánchez Lite, M. OTERO, A. B. Gil Guerra, M. Jiménez Cuenca, J. Rodriguez Jimenez; Valladolid/ES

DOI:

10.26044/ecr2020/C-00330

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-00330

Fig. 2: Schematic coronal view depicts a nodular “bubbly-appearing” lesion located...

Fig. 1: The 2016 World Health Organization Classification of Tumors of the Central...

Fig. 4: T2 axial sequence which shows a temporoparietal corticosubcortical lesion,...

Fig. 5: T2 axial sequence which shows a temporoparietal corticosubcortical lesion,...

Learning objectives

Definition and historical context. Review of2016 World Health Organization classification of tumors of the central nervous system. Epidemiology and clinical presentation. MVNT histopathological substrate. Imaging findings. Case report. Differential diagnosis. Treatment and prognosis. Conclusions.

Background

1. Definition and historical context. Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion, that is included in the 2016 updated World Health Organization classification of brain neoplasms, as a unique cytoarchitectural pattern of gangliocytoma. 2. 2016 WHO classification of tumors of the central nervous system. The 2016 World Health Organization Classificationof Tumors of the Central Nervous System is both a conceptual and practical advance over its 2007 predecessor (Fig. 1) WHO classification uses molecular parameters in...

Findings and procedure details

Imaging findings CT: These tumors are very difficult to identify in CT. If seen, they will appear as non-enhancing low attenuation lesions in the subcortical white matter. MRI: Well circumscribed high T2 signal 'bubbles' located predominantly in the subcortical white matter. T1: Hypointense. T2/FLAIR: Hyperintense. Contrast enhancement T1: No enhancement. Diffusion: Absence of restricted diffusion. Case Report Case 1: 31-year-old men under study due to recent generalized tonic-clonic epileptic seizures. Right temporoparietal corticosubcortical lesion, microcystic, hyperintense in T2 / FLAIR and with no contrast enhancement...

Conclusion

Multinodular and vacuolating neuronal tumour (MVNT), is a new neuronal cytoplasmic pattern described in the WHO of CNS tumors 2016. They are benign, multinodular and well circumscribed lesions. Characteristic imaging findings include: lesions are non-contrast enhancing, T2/FLAIR hyperintense, involving the cortex and superficial white matter, with absence of restricted diffusion and mass effect. MVNT may or may not be symptomatic and may be found incidentally. DNET is the most common differential diagnosis. When incidentally discovered, MVNT can be sufficiently managed on surveillance imaging to ensure...

Personal information and conflict of interest

S. Osorio Aira; Valladolid/ES - nothing to disclose M. M. Rodriguez Velasco; Valladolid/ES - nothing to disclose M. Sanchez Ronco; Valladolid/ES - nothing to disclose R. Petruzzella Lacave; Valladolid/ES - nothing to disclose I. Sanchez Lite; Valladolid/ES - nothing to disclose M. Otero Mongil; Valladolid/ES - nothing to disclose S. Joral Del Hoyo; Valladolid/ES - nothing to disclose A. B. Gil Guerra; Valladolid/ES - nothing to disclose M. Jiménez Cuenca; Valladolid/ES - nothing to disclose

References

Shitara, S., Tokime, T., & Akiyama, Y. (2018). Multinodular and vacuolating neuronal tumor: A case report and literature review.Surgical neurology international,9, 63. doi:10.4103/sni.sni_348_17 HuseJT, EdgarM, HallidayJ,et al Multinodular and vacuolating neuronal tumors of the cerebrum: 10 cases of a distinctive seizure-associated lesion.Brain Pathol2013;23:515–24doi:10.1111/bpa.12035pmid:23324039 R.H. Nunes, C.C. Hsu, A.J. da Rocha, L.L.F. do Amaral, L.F.S. Godoy, T.W. Watkins, V.H. Marussi, M. Warmuth-Metz, H.C. Alves, F.G. Goncalves, B.K. Kleinschmidt-DeMasters and A.G. Osborn.Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New “Leave Me Alone” Lesion with a...