Background and Purpose:
Diffuse leptomeningeal glioneuronal tumors (DL-GNT) are rare
glioneuronal neoplasms with oligodendroglioma-like cells. These tumors can present as a dominant
intracranial mass or as a solitary spinal cord mass without leptomeningeal involvement. In this study,
we aimed to determine the magnetic resonance imaging and histopathological features, treatment modalities, and clinical outcomes of the parenchymal forms of DL-GNTs.
Methods:
This is a retrospective three-center case series study of 5 patients with a confirmed parenchymal form of DLGTs, out of which 4 patients were adults. Brain and spinal cord MR imaging were
performed in all patients at either 1.5 or 3T. The patients' age ranged from 5 years to 50 years with a
mean age of 27.6 years at presentation.
objective:
These tumors can present as a dominant intracranial mass or as a solitary spinal cord mass without leptomeningeal involvement.
Results:
Four of the tumors were located in the frontal lobe, and one in the tectum. They were usually
solid-cystic enhancing tumors as the other mixed neuronal-glial tumors. All of the tumors had an extension to the superficial surface of a cerebral hemisphere. One had systemic bone metastases. The
clinical signs and symptoms of the parenchymal form varied based on the location of the mass, in contrast to the leptomeningeal form associated with hydrocephalus. In one case, the tumor’s initial grade
was defined as intermediate. The initial histopathology of the two cases was low-grade and no upgrade occurred in the follow-up period. In two cases, although the tumors were low grade initially, they
progressed to an anaplastic form in the follow-up period.
Conclusion:
The parenchymal form of DL-GNTs is common in adults. Extension to the superficial
surface of a cerebral hemisphere is a distinctive imaging feature. Systemic osseous metastasis may
occur. Due to the presence of common histopathological features, including the biphasic composition
of glial and neuronal cell elements and oligodendroglioma-like cells, a proposed classification approach might be more beneficial for the histopathological and imaging description, and management of
the glioneuronal tumors with oligodendroglioma-like features.
other:
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Uveal melanoma has a high metastasis rate. Following the initial diagnosis, up to 50% of patients are affected by late recurrence and gastrointestinal metastasis is found to be one of the least frequent. We report the case of a 47-year-old woman who underwent proton therapy for uveal melanoma. Fourteen years after the initial diagnosis, she presented to the hospital complaining of an enduring gas in stomach. Dark colored, metastatic lesions were discovered in gastric mucosa during endoscopy and hyperintense hepatic lesions were spotted in T1 weighted MR imaging. Long term metastasis is commonly seen in patients with uveal melanoma and its management is more difficult when compared to other melanoma types, hence regular follow-ups are crucial for patient well-being. Keywords: uveal melanoma; gastric metastases; mucosal metastases; gastric mucosa; intraocular tumors.
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