Presentation
Epilepsy
Patient Data
In the left temporal lobe, there is a well-defined, multilobulated 'bubbly' mass measuring approximately 23 x 26 x 50 mm. It exhibits a hypointense signal on T1WI, mixed-signal intensity with a bright rim sign, and a hyperintense signal on T2WI, with a multicystic structure and no restricted diffusion, calcification, or haemorrhage. Adjacent parenchymal oedema is absent, and mild nodular pattern enhancement is observed within the tumour.
DTI images were obtained for preoperative planning.
The specimen appeared grey and soft, measuring from 3 x 3 x 1 mm to 30 x 15 x 5 mm.
Microscopic description:
On two slides prepared from the received specimen and stained with haematoxylin and eosin (HE), the specimen received was brain tissue containing a tumour. The tumour exhibits unclear boundaries, and its tissue appears heterogeneous. Within the tumour, there is an area composed of small, uniformly oligonucleated cells arranged along capillaries. This area is interspersed with mucous stroma rich in nerve fibres and scattered with benign-appearing floating neurones. Additionally, the tumour contains a glioma-like region with numerous oligodendrocyte-shaped cells clustered together. No atypical cells, mitosis, or necrosis were observed.
Conclusion:
Dysembryoplastic neuroepithelial tumour - DNET, complex variant.
After surgery, a part of the left temporal lobe was removed, causing gliosis in the surrounding area and dilation of the left lateral ventricle's temporal horn.
Case Discussion
These findings are typical characteristics of a dysembryoplastic neuroepithelial tumour (DNET).
DNET is one of the two most common tumours associated with long-term epilepsy.
The temporal lobes are the most common location, accounting for approximately 45–50% of cases.
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