NEUROPATHOLOGIC FINDINGS IN DYSEMBRYOPLASTIC NEUROEPITHELIAL TUMOR (DNT): CORRELATION WITH ADJACENT CORTICAL DYSPLASIA
Abstract number :
1.461
Submission category :
Year :
2003
Submission ID :
2513
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Ryoichi Sakuta, Hitoshi Otsubo, Melinda A. Nolan, Shelly K. Weiss, Cynthia Hawkins, James T. Rutka, Nathaniel A. Chuang, Sylvester H. Chuang, O. Carter Snead Division of Pathology, DPLM, The Hospital for Sick Children, University of Toronto, Toronto, ON,
The present study intends to identify factors of pathological features that predict postoperative clinical outcome in children with seizures secondary to dysembryoplastic neuroepithelial tumor (DNT).
We retrospectively reviewed pathologies of patients who underwent epilepsy surgery between 1993 and 2002 at The Hospital for Sick Children, Toronto. We reviewed clinical, radiological and neuropathological features.
There were 13 males and 13 females. Mean age at onset of seizures was 7 years (range: 2 to 13 years). The mean age at surgery was 10 years (4 to 18 years). Fifteen patients experienced complex partial seizures, 7 patients complex partial seizures with secondary generalized seizures, 3 patients simple partial seizures and one patient with tuberous sclerosis who had infantile spasms developed partial seizures. Nine tumors were located in the temporal lobe, 9 in frontal lobe, 6 in parietal lobe, 1 in occipital lobe and 1 in front-parietal lobe. Histopathological characteristics of DNTs include the specific glioneuronal elements in all patients. The main pathological type of DNT was complex type in 18 patients (69%), and DNT accompanied with adjacent cortical dysplasia in 17 patients (65%). In the 17 patients of DNT with adjacent cortical dysplasia, 7 were Palmini[apos]s classification grade 1, 8 were grade 2 and two were grade 3. Postsurgical follow-up ranged 1 to 14 years (mean 4 years): 17 patients were seizure free and 9 have been presenting seizures including 8 patients with CD. There was a statistical siginificance between 7 of 17 patients (41%) with DNT and CD requiring further surgeries due to recurrent intractable seizures, and none of 9 patients without CD requiring second surgery. There was no correlation between existence and grades of CD, and postsurgical seizure outcomes.
Children with DNT and CD often had recurrent seizures and required further epilepsy surgery. Adjacent CD may play a role of epileptogenesis in DNT, thus the appropriate resection of DNT and adjacent CD should be considered.