J Korean Soc Radiol.  2018 Jan;78(1):44-48. 10.3348/jksr.2018.78.1.44.

Glioneuronal Tumor with Neuropil-Like Islands in the Cerebellum: A Case Report

• Lee YJ
• Hwang YS
• Chang ED
• Lee TK
• Kim YJ

• KMID: 2399305
• DOI: http://doi.org/10.3348/jksr.2018.78.1.44

Abstract

Glioneuronal tumor with neuropil-like islands (GTNI) is a rare and novel mixed neuronal-glial tumor that typically affects the supratentorial cerebral hemispheres of adult patients. It is extremely rare for GTNIs to be in the spine of pediatric and adolescent patients, and there have been no reports of infratentorial GTNIs. We report a case of an elderly patient with an anaplastic, infratentorial GTNI that occurred in the cerebellum, including describing MRI features of our case.

MeSH Terms

Adolescent
Adult
Aged
Cerebellar Neoplasms
Cerebellum*
Cerebrum
Humans
Islands*
Magnetic Resonance Imaging
Neuropil
Spine

Figure

• 

  Fig. 1 A 75-year-old woman with anaplastic glioneuronal tumor with neuropil-like islands. A. Unenhanced axial CT scan demonstrates ill-defined hypodensity in the left cerebellar hemisphere. B. The mass exhibits hyper-intensity on axial T2-weighted image (upper left panel) with minimal peritumoral edema and heterogeneously strong enhancement on axial post-contrast T1-weighted image (upper central panel). On diffusion images, the mass exhibits a mainly hypo-intense signal on diffusion weighted image (upper right panel) without diffusion restriction and a higher apparent diffusion coefficient (lower left panel) relative to brain parenchyma. Axial post-contrast T1-weighted image on first day after gross total resection (lower central panel) reveals residual enhancement along the margin of the resection cavity. The three-months postoperative MR image (lower right panel) reveals widespread enhancement with distinct margin in the surgical bed. C. The CBV map reveals low CBV within the lesion. D. Single-voxel intermediate echo time (135 ms) MR spectroscopy demonstrates elevated choline/creatine and choline/N-acetylaspartate peaks. E. Photomicrograph of hematoxylin and eosin stained slide (magnification × 100) reveals spindled or elongated astrocytic cells with well-delineated micronodular, neuropil-like islands and central capillaries. CBV = cerebral blood volume F. Positive glial-fibrillary acid protein stain (left panel, magnification × 100) indicates a glial component. Synaptophysin stain (right panel, magnification × 100) revealed positive staining in part of the tumor, indicating a neuronal component.

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