Dysembryoplastic neuroepithelial tumor diagnosis

• Differentiation of multinodular and vacuolating neuronal tumor and dysembryoplastic neuroepithelial tumor based on MRI
• Epilepsy in patients with pediatric brain tumors: Etiology, treatment & management
• Metachronous tumour (DNET and haemorrhagic chiasmal tumour) in a patient with encephalocraniocutaneous syndrome (ECCL)
• The Mickey Mouse's hand sign in brain MRI points out multinodular and vacuolating neuronal tumors in mesial temporal lobe structures
• Atypical Lesions in Virchow-Robin Spaces: A Case Report
• Myxoid glioneuronal tumor of the septum pellucidum in pediatric patients: a case report and comprehensive review of the literature
• A glioneuronal tumor with neurocytic rosettes harboring FGFR1 internal tandem duplication - A report of a unique case
• Seizure outcome in surgically treated pediatric gangliogliomas and dysembryoplastic neuroepitheliomas according to imaging and resection strategies

According to Daumas-Duport and colleagues, the criteria for the diagnosis of Dysembryoplastic neuroepithelial tumor should include:

(1) partial seizures, with or without secondary generalization beginning before age 20

(2) no neurological deficit or presence of a stable and likely congenital neurological deficit

(3) cortical topography of the lesion as best demonstrated on MRI

(4) no mass effect on CT or MRI (except if related to a cyst) ¹⁾.

Radiographic features

DNETs are typically predominantly cortical and well circumscribed tumours.

CT

if cortical may scallop the inner table of of the skull vault (44-60%), but no erosion the cranial fossa can be minimally enlarged at times calcification in ~30% (more common histologically) low density no enhancement MRI

Typically seen as a cortical lesion with hardly any surrounding vasogenic oedema.

T1

​generally hypointense c.f adjacent brain

T1 C+ (Gd)

may show enhancement in ~20-30% of cases, enhancement may be heterogeneous or a mural nodule

T2 ​generally high signal high signal 'bubbly appearance' FLAIR ​mixed signal intensity with bright rim sign partial suppression of some of the “bubbles” FLAIR is helpful in identifying the small peripheral lesions with similar intensity to CSF T2* calcification relatively frequent ​haemosiderin staining uncommon as bleeding into DNETs is only occasional DWI ​no restricted diffusion MR spectroscopy ​non-specific although lactate may be present