title: Dynamic changes in magnetic resonance imaging appearance of dysembryoplastic neuroepithelial tumor with or without malignant transformation.
abstract: Dysembryoplastic neuroepithelial tumors (DNETs) have conventionally been regarded as benign and stable tumors and considered curable with surgery without adjunctive therapy. Recently, recurrent DNETs with or without malignant transformation have been described. The authors report 2 unusual cases of DNET: 1) an enlarging lesion that developed an enhancing component over the natural course of 4 years, and 2) a recurrent DNET that developed an enhancing component 10-11 years after gross-total resection. The patient in the first case was treated with subtotal resection and adjuvant radiochemotherapy; histological examination of the tumor led to the diagnosis of DNET, WHO Grade I, for the nonenhancing component and anaplastic oligodendroglioma, WHO Grade III, for the enhancing component. The patient in the second case was treated with repeat gross-total resection; the original tumor had been histologically diagnosed as DNET, and the nonenhancing and enhancing components of the recurrent tumor were diagnosed as simple and complex forms of DNET, respectively. These and previous reports suggest an aggressive subtype of DNETs. If follow-up MRI reveals progressive behavior, resection should be performed without delay. Additional radiochemotherapy is needed if the histological diagnosis demonstrates malignant transformation.
authors: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors: Yui
authors: Y
authors: Mano
authors: Toshihiro
authors: T
authors: Kumabe
authors: Ichiyo
authors: I
authors: Shibahara
authors: Ryuta
authors: R
authors: Saito
authors: Yukihiko
authors: Y
authors: Sonoda
authors: Mika
authors: M
authors: Watanabe
authors: Teiji
authors: T
authors: Tominaga
mesh_terms: D001932:Brain Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D002675:Child, Preschool; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000235:genetics; D056915:DNA Copy Number Variations; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D005784:Gene Amplification; D006801:Humans; D007150:Immunohistochemistry; D007521:Isocitrate Dehydrogenase / Q000235:genetics; D008279:Magnetic Resonance Imaging; D008297:Male; D018302:Neoplasms, Neuroepithelial / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D051059:PTEN Phosphohydrolase / Q000235:genetics; D010784:Photomicrography; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012086:Reoperation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16; D066246:ErbB Receptors; D007521:Isocitrate Dehydrogenase; D051059:PTEN Phosphohydrolase; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53; C495901:TP53 protein, human; C538784:IDH2 protein, human; C543588:IDH1 protein, human; C508053:ERBB2 protein, human; C494929:PTEN protein, human