Posted By Gabriela Abrego

A 21 years old female patient was presented to the ER with severe, episodic frontal headaches associated with nausea, vomiting and difficulties with balance. Magnetic Resonance (MR) images of the brain without and with Gadolinium administration depicted a focal lesion located at the medial margin of the left cerebellum, measuring 1.6 x 1.2 x 1.6 cm in anterior posterior, transverse and craniocaudal diameters respectively. This lesion was T1 hypointense, T2 hyperintense and with mixed signal behavior on FLAIR images suggesting cystic degeneration. There was no appreciable enhancement on post gadolinium T1 images. There was no evidence of diffusion abnormalities or restriction in the apparent diffusion coefficient (ADC) map. The initial diagnostic impression by imaging findings favored an atypical pilocytic astrocytoma versus a low-grade diffuse fibrillary astrocytoma. Patient was scheduled for the tumor resection. After getting a localizing MR scan, she was taken to the operating room. The tumor was resected and hemostasis was assured. The surgical cavity was filled up with an absorbable hemostat material, the dura was closed and a cranioplasty was performed. The specimen received for intraoperative consultation and subsequent examination was fragmented, soft and gelatinous. The histologic features and immunophenotype were characteristic of dysembryoplastic neuroepithelial tumor. Clinical outcome was favorable and uncomplicated. The patient was discharged from hospital three days after surgery. The current report highlights the need to consider this entity in the differential diagnosis of infratentorial neoplasms.

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  • Roland Talanow 2015-05-14 02:14:34

    This paper is based on a Medline search from 1988 until December 2005. There are 10 years missing till now and I am sure - with the surge of online journals and publications - more has been published. I would do a more uptodate research for more accurate/timely numbers.

    This is not infrequent scenario: We receive from time to time submissions that claim rarity of a case but based on older publications. It might be still that rare, but it needs to be founded by an uptodate literature investigation. Thank you for considering this advise.


  • Gabriela Abrego 2015-05-13 12:30:36

    Dysembryoplastic neuroepithelial tumors are most frequently located in the cortical gray matter of the temporal lobe, but have also been reported to arise within the caudate nucleus, cerebellum or pons. To our knowledge, this unique location (cerebellum) has only been reported in six patients previously [Mussi MGD, Alves-leon SV, Thuler LCS. Systematic review of the dysembryoplastic neuroepithelial tumor characteristics. Applied Cancer Research. 2008;28(3):85-92].

    Our report also highlights the need to consider this entity in the differential diagnosis of infratentorial neoplasms.


  • Roland Talanow 2015-05-04 20:11:54

    Nice case description!

    Could you please explain what makes this case report special if you want it to be published. Thank you.