Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease) presenting as a prenatally heterotopic hamartoma

Childs Nerv Syst. 2021 Mar;37(3):1017-1020. doi: 10.1007/s00381-020-04785-2. Epub 2020 Jul 3.

Abstract

Dysplastic gangliocytoma of the cerebellum (DGC), also called Lhermitte-Duclos disease, is a rare lesion of the posterior fossa consisting of a diffuse hypertrophy of the cerebellar cortex. DGC frequently presents in young adults and rarely in childhood. Only 3 cases have been previously described in newborns. We present an uncommon case of DGC which was diagnosed in utero. The radiological presentation prenatally and at birth was similar to a heterotopic neuroglial brain tissue. MRI aspects evolved from T1/T2 isointense signals to hypoT1 and hyperT2 signals at the age of 1 year. The girl was then operated on total removal of the lesion which was performed with no postoperative complication. Genetics did not demonstrate any germline PTEN mutation or family history suggesting Cowden disease. Two years later, the child was doing well and MRI confirmed complete resection. This case illustrates the difficulties of diagnosing intracranial lesions in foetuses and newborns. Physicians caring for pregnant women and pediatrics should be aware that neoplasm-like lesions such as DGC may present as hamartomas. Surgical resection could then be discussed whenever possible.

Keywords: Cerebellum; Dysplactic gangliocytoma; Lhermitte-Duclos disease; MRI; Newborn; Prenatal diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Cerebellar Neoplasms*
  • Cerebellum / diagnostic imaging
  • Cerebellum / surgery
  • Child
  • Female
  • Ganglioneuroma* / diagnostic imaging
  • Ganglioneuroma* / surgery
  • Hamartoma Syndrome, Multiple* / diagnostic imaging
  • Hamartoma* / diagnostic imaging
  • Hamartoma* / surgery
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Pregnancy