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

Authors
  • Puiseux, Chloé1
  • Bretonnier, Maxime2
  • Proisy, Maia3
  • Chappé, Céline1
  • Denizeau, Philippe4
  • Riffaud, Laurent5, 6
  • 1 Department of Pediatric Oncology, Rennes University Hospital, Rennes, France. , (France)
  • 2 Department of Pediatric Neurosurgery, Rennes University Hospital, Rennes, France. , (France)
  • 3 Department of Pediatric Radiology, Rennes University Hospital, Rennes, France. , (France)
  • 4 Department of Clinical Genetics, Rennes University Hospital, Rennes, France. , (France)
  • 5 Department of Pediatric Neurosurgery, Rennes University Hospital, Rennes, France. [email protected] , (France)
  • 6 INSERM MediCIS, unit U1099 LTSI, Rennes 1 University, Rennes, France. [email protected] , (France)
Type
Published Article
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
Publication Date
Jul 03, 2020
Identifiers
DOI: 10.1007/s00381-020-04785-2
PMID: 32621005
Source
Medline
Keywords
Language
English
License
Unknown

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.

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