Multinodular and vacuolating neuronal tumor of the cerebrum: Two cases and review of the literature

Abstract

Background: Multinodular and vacuolating neuronal tumor (MVNT) recently described as a purely neuronal tumor. Although its nature as a genuine tumor is controversial, this new entity assumed benign lesion and mostly affecting adults. Herein, we introduce two cases of MVNT presumed low grade glial tumor (LGG) and focal cortical dyplasia (FCD) as a differential diagnosis.

Case description: Case 1 has admitted to our hospital with headache which frequency and severity has increased within two months. Radiological examination revealed hyperintensity on T2-WI and T2 FLAIR images. Microsurgical resection was performed and histopathological findings were compatible with MVNT instead of low grade glial tumor as we thought. Case 2, who presented at our hospital with one episode seizure. MRI showed T2 hyperintensity and T1 hypointensity without contrast enhancement. We suspected FCD, thus performed microsurgical gross total resection with frontal craniotomy. Pathological findings confirmed MVNT as a diagnosis. Both cases were discharged on the 3rd day after surgery without any complications and with no regrowth of tumor at the 9-months and 3-months follow-up respectively.

Conclusions: Radiological hallmarks may be helpful to prevent from aggressive treatment in case of patient is asemptomatic. Nevertheless further studies are necessary for the adoption of 'wait and see' philosophy and give a verdict about benign nature of these tumors.

Keywords: DNET; Low grade glioma; MRI; Multinodular and vacuolating neuronal tumor; Seizure.