Dysembryoplastic neuroepithelial tumour: Features in 16 patients

Raymond Azman Ali, S. F S Halpin, N. Alsanjari, M. J. Cook, N. D. Kitchen, D. R. Fish, J. M. Stevens, B. N. Harding, F. Scaravilli, B. Kendall, S. D. Shorvon, B. G R Neville

Research output: Contribution to journalArticle

147 Citations (Scopus)

Abstract

Dysembryoplastic neuroepithelial tumour (DNT) is a newly recognized brain mass lesion with distinctive pathological features and a favourable prognosis. We reviewed the clinical, electroencephalographic, neuroimaging and pathological features of 16 patients with DNT who underwent surgery; only one patient did not have epilepsy. Mean age at seizure onset was 9.5 years (range: 1 week to 30 years) and surgery 17 years (range: 7 months to 37 years). The mean verbal IQ was 94.6 (range: 79-110) and performance IQ 105 (range: 79-130) (n = 10). The EEG was abnormal in all cases reviewed (n = 13): localized slow activity was seen in 12 and interictal spiking in 10 patients, being less extensive than or concordant with the lesion in three and more extensive than or distant to the lesion in seven. X-ray CT was normal in three out of 11 patients. Magnetic resonance imaging provided detailed anatomical information: the lesion was predominantly intracortical, although in six patients, there was also white matter involvement. The lesion involved the temporal lobe in all but one patient where it was in the cingulate gyrus. Of the temporal lobe cases, MRI showed that the lesion involved, or was in close proximity to, mesial temporal structures in 11 out of 14 patients. Other magnetic resonance features included: circumscribed hyperintensity on long TE/TR images (10 patients), hypointensity on short TR images (12 patients), and cyst formation (five patients). Calcification was seen on CT in four patients. Post surgical follow-up ranged from 8 to 30 months (mean 16.2 months): 12 patients are seizure free and two have a >80% reduction in seizure frequency (n = 14). Histopathological characteristics included a heterogeneous composition in all cases, calcification (13 cases), dysplastic features (12 cases) and isolated foci of subpial spread (five cases). The presence of occasional mitoses in 12 cases and immunoreactivity to the proliferating cell nuclear antigen in six cases indicate that these lesions have cellular proliferative activity and that there may be a need to follow these patients postoperatively.

Original languageEnglish
Pages (from-to)461-475
Number of pages15
JournalBrain
Volume117
Issue number3
Publication statusPublished - Jun 1994
Externally publishedYes

Fingerprint

Neuroepithelial Neoplasms
Magnetic resonance imaging
Surgery
Tumors
Tumor
Neuroimaging
neoplasms
Magnetic resonance
Antigens
lesions (animal)
Electroencephalography
Range of data
Brain
X rays
Epilepsy
Magnetic Resonance
Prognosis
Magnetic Resonance Imaging
Chemical analysis
seizures

Keywords

  • Dysembryoplastic neuroepithelial tumour
  • Epilepsy
  • MRI
  • Neoplastic

ASJC Scopus subject areas

  • Neuroscience(all)
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Mathematics(all)
  • Statistics and Probability
  • Agricultural and Biological Sciences (miscellaneous)
  • Clinical Neurology

Cite this

Ali, R. A., Halpin, S. F. S., Alsanjari, N., Cook, M. J., Kitchen, N. D., Fish, D. R., ... Neville, B. G. R. (1994). Dysembryoplastic neuroepithelial tumour: Features in 16 patients. Brain, 117(3), 461-475.

Dysembryoplastic neuroepithelial tumour : Features in 16 patients. / Ali, Raymond Azman; Halpin, S. F S; Alsanjari, N.; Cook, M. J.; Kitchen, N. D.; Fish, D. R.; Stevens, J. M.; Harding, B. N.; Scaravilli, F.; Kendall, B.; Shorvon, S. D.; Neville, B. G R.

In: Brain, Vol. 117, No. 3, 06.1994, p. 461-475.

Research output: Contribution to journalArticle

Ali, RA, Halpin, SFS, Alsanjari, N, Cook, MJ, Kitchen, ND, Fish, DR, Stevens, JM, Harding, BN, Scaravilli, F, Kendall, B, Shorvon, SD & Neville, BGR 1994, 'Dysembryoplastic neuroepithelial tumour: Features in 16 patients', Brain, vol. 117, no. 3, pp. 461-475.
Ali RA, Halpin SFS, Alsanjari N, Cook MJ, Kitchen ND, Fish DR et al. Dysembryoplastic neuroepithelial tumour: Features in 16 patients. Brain. 1994 Jun;117(3):461-475.
Ali, Raymond Azman ; Halpin, S. F S ; Alsanjari, N. ; Cook, M. J. ; Kitchen, N. D. ; Fish, D. R. ; Stevens, J. M. ; Harding, B. N. ; Scaravilli, F. ; Kendall, B. ; Shorvon, S. D. ; Neville, B. G R. / Dysembryoplastic neuroepithelial tumour : Features in 16 patients. In: Brain. 1994 ; Vol. 117, No. 3. pp. 461-475.
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abstract = "Dysembryoplastic neuroepithelial tumour (DNT) is a newly recognized brain mass lesion with distinctive pathological features and a favourable prognosis. We reviewed the clinical, electroencephalographic, neuroimaging and pathological features of 16 patients with DNT who underwent surgery; only one patient did not have epilepsy. Mean age at seizure onset was 9.5 years (range: 1 week to 30 years) and surgery 17 years (range: 7 months to 37 years). The mean verbal IQ was 94.6 (range: 79-110) and performance IQ 105 (range: 79-130) (n = 10). The EEG was abnormal in all cases reviewed (n = 13): localized slow activity was seen in 12 and interictal spiking in 10 patients, being less extensive than or concordant with the lesion in three and more extensive than or distant to the lesion in seven. X-ray CT was normal in three out of 11 patients. Magnetic resonance imaging provided detailed anatomical information: the lesion was predominantly intracortical, although in six patients, there was also white matter involvement. The lesion involved the temporal lobe in all but one patient where it was in the cingulate gyrus. Of the temporal lobe cases, MRI showed that the lesion involved, or was in close proximity to, mesial temporal structures in 11 out of 14 patients. Other magnetic resonance features included: circumscribed hyperintensity on long TE/TR images (10 patients), hypointensity on short TR images (12 patients), and cyst formation (five patients). Calcification was seen on CT in four patients. Post surgical follow-up ranged from 8 to 30 months (mean 16.2 months): 12 patients are seizure free and two have a >80{\%} reduction in seizure frequency (n = 14). Histopathological characteristics included a heterogeneous composition in all cases, calcification (13 cases), dysplastic features (12 cases) and isolated foci of subpial spread (five cases). The presence of occasional mitoses in 12 cases and immunoreactivity to the proliferating cell nuclear antigen in six cases indicate that these lesions have cellular proliferative activity and that there may be a need to follow these patients postoperatively.",
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