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Incidentally Discovered Papillary Glioneuronal Tumor with 3‐Year Follow‐up
Author(s) -
Newell Kathy L,
Fiorella Russell M,
Gianino John W
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.706.30
Subject(s) - medicine , synaptophysin , craniotomy , pathology , glial fibrillary acidic protein , fourth ventricle , papillary tumor , neurosurgery , central neurocytoma , radiology , magnetic resonance imaging , immunohistochemistry
Papillary glioneuronal tumor (PGNT) is a newly recognized entity in the 2007 WHO classification of central nervous system tumors. We report a case of an incidentally detected PGNT discovered while yet clinically silent. A 20 year‐old pregnant woman suffered minor head injury and underwent CT and MR imaging, revealing a 6 cm right frontal lobe solid‐cystic mass. Neurosurgery was deferred until delivery of the infant. Repeat MRI 6 months later showed enlargement of the mass with development of significant edema and effacement of the right lateral ventricle. A right frontal craniotomy for tumor resection was then performed. Histologically, solid portions of the tumor included a pseudopapillary architecture with hyalinized vascular walls lined by small glial fibrillary acidic protein‐immunoreactive cells. Interspersed islands of round synaptophysin‐immunoreactive cells were also present. The cyst wall contained abundant Rosenthal fibers and areas of vascular proliferation with rare mitoses and modest Ki‐67 proliferative activity. Postoperatively, the patient developed infrequent complex partial seizures that have been well‐controlled with phenytoin. At 2.5 years following tumor resection, the patient is neurologically intact, and surveillance MRI shows no tumor recurrence. This unique case contributes additional insights into clinical presentation and behavior of this relatively benign WHO grade I tumor.