Skip to main content

Advertisement

SpringerLink
Log in

Conventional, diffusion, and permeability MR findings in ocular medulloepithelioma

  • Paediatric Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

To describe the neuroradiological features of intraocular medulloepithelioma.

Methods

We retrospectively analyzed the clinical, histopathological, and MRI data of five children with medulloepithelioma. In addition to conventional images, DWI was performed in four patients and mean ADC was calculated; this was limited to the technique of this cohort of patients. DCE was performed in all patients. This is the first paper that presents diffusion and perfusion characteristics of medulloepithelioma.

Results

Four tumors were malignant teratoid variants, two non-teratoid variants. Tumors were hyperintense on T1-weighted images and hypointense on T2-weighted images. Calcifications were detectable in two out of five tumors. Cavities were detectable in three out of five tumors. All tumors showed some degree of enhancement. The mean ADC of all four patients was 1.156 ± 242.75 × 10−3 mm2/s. Mean ktrans, Ve, Kep, TME, AUC, SER, and peak enhancement were 0.082 ± 0.054, 0.19 ± 0.076, 0.31 ± 0.084, 0.97 ± 0.0784, 1.22 ± 0.81, 67.34 ± 31.7, and 14.84 ± 7.34 respectively. TICs showed a very high ratio of slow increase, > 50% persistence and some degree of wash out. Teratoid variants showed higher K-trans, AUC, VE, TME, and persistent TIC pattern than non-teratoid ones, while plateau pattern ratio was lower.

Conclusion

Conventional MR findings were similar to previously reported cases. Mean ADCs were moderately high. TICs showed slow increase and presence of wash out. K-trans, AUC, VE, and TME were higher in teratoid variants. Permeability parameters in differential diagnosis with lesions mimicking medulloepithelioma need further investigations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Saunders T, Margo CE (2012) Intraocular medulloepithelioma. Arch Pathol Lab Med 136:212–216

    Article  CAS  Google Scholar 

  2. Zimmerman LE (1971) Verhoeff’s “terato-neuroma.” A critical reappraisal in light of new observations and current concepts of embryonic tumors. Am J Ophthalmol 72:1039–1057

    Article  CAS  Google Scholar 

  3. Cerase A, De Francesco S, Citterio A, Hadjistilianou T, Malandrini A, Mastrangelo D, Toti P, Venturi C (2010) Growth of congenital malignant teratoid medulloepithelioma of the ciliary body: a case study. J Neuro-Oncol 96:443–448

    Article  Google Scholar 

  4. McLendon RE, Judkins AR, Eberhart CG, Fuller GN, Sarkar C, Ng HK (2007) Central nervous system primitive neuroectodermal tumours. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO classification of tumours of the nervous system. IARC, Lyon, pp 141–146

    Google Scholar 

  5. Pushker N, Khuraijam N, Sen S, Bajaj M, Mehta M (2008) Medulloepithelioma of the ciliary body associated with massive intravitreal hemorrhage in an adult. Can J Ophthalmol 43:253–254

    Article  Google Scholar 

  6. Broughton WL, Zimmerman LE (1978) A clinicopathologic study of 56 cases of intraocular medulloepitheliomas. Am J Ophthalmol 85:407–418

    Article  CAS  Google Scholar 

  7. Shields JA, Shields CL (1999) Miscellaneous intraocular tumors. In: Shields JA, Shields CL (eds) Atlas of intraocular tumors. Lippincott, Williams & Wilkins, Philadelphia, pp 310–315

    Google Scholar 

  8. Shields JA, Eagle RC, Shields CL et al (1996) Congenital neoplasms of the non pigmented ciliary epithelium (medulloepithelioma). Ophthalmology 103(12):1998–2006

    Article  CAS  Google Scholar 

  9. Husain S, Husain N, Boniuk M, Font RL (1998) Malignant nonteratoid medulloepithelioma of the ciliary body in an adult. Ophthalmology 105:596–599

    Article  CAS  Google Scholar 

  10. Sosinska-Mielcarek K, Senkus-Konefka E, Jaskiewicz K, Kordek R, Jassem J (2006) Intraocular malignant teratoid medulloepithelioma in an adult: clinicopathological case report and review of the literature. Acta Ophthalmol Scand 84:259–262

    Article  Google Scholar 

  11. Zimmerman LE, Broughton WL (1978) A clinicopathologic and follow-up study of fifty-six intraocular medulloepitheliomas. In: Jackobiec FA (ed) Ocular and adnexal tumors. Aesculapius Publishing, Birmingham, pp 181–196

    Google Scholar 

  12. Sansgiri RK, Wilson M, Carville MB, Helton KJ (2013) Imaging features of medulloepithelioma: report of four cases and review of the literature. Pediatr Radiol 43:1344–1356

    Article  Google Scholar 

  13. Karcioglu ZA, Abboud EB, Al-Mesfer SA et al (2002) Retinoblastoma in older children. JAAPOS 6(1):26–32

    Google Scholar 

  14. Mamalsi N, Font RL, Anderson CW et al (1992) Concurrent benign teratoid medulloepithelioma and pineoblastoma. Ophthalmic Surg 23(6):403–408

    Google Scholar 

  15. Steinkuller PG, Font RL (1997) Congenital malignant teratoid neoplasms of the eye and orbit: a case report and review of the literature. Ophthalmology 104(1):38–42

    Article  CAS  Google Scholar 

  16. Yanko L, Behar A (1978) Teratoid intraocular medulloepithelioma. Am J Ophthalmol 85:850–853

    Article  CAS  Google Scholar 

  17. Carrillo R, Streeten BW (1979) Malignant teratoid medulloepithelioma in an adult. Arch Ophthalmol 97:695–699

    Article  CAS  Google Scholar 

  18. Verdijk R (2016) On the classification and grading of medulloepithelioma of the eye. Ocular Oncology and Pathology 2:190–193

    Article  Google Scholar 

  19. Galluzzi P, Cerase A, Hadjistilianou T, de Francesco S, Toti P, Vallone IM, Filosomi G, Monti L, Bracco S, Gennari P, Ginanneschi C, Venturi C (2003) Retinoblastoma: abnormal gadolinium-enhancement of the anterior segment of eyes at MR imaging with clinical and pathological correlation. Radiology 228:683–690

    Article  Google Scholar 

  20. Galluzzi P, Hadjistilianou T, Cerase A, De Francesco S, Toti P, Venturi C (2009) Is CT still useful in the study protocol of retinoblastoma? AJNR Am J Neuroradiol 30:1760–1765

    Article  CAS  Google Scholar 

  21. Rodjan F, de Graaf P, van der Valk P, Hadjistilianou T, Cerase A, Toti P, de Jong PC, Moll AC, Castelijns AJ, Galluzzi P, on behalf of the European Retinoblastoma Imaging Collaboration (2015) Detection of calcifications in retinoblastoma using gradient-echo MR imaging sequences: comparative study between in vivo MR imaging and ex vivo high-resolution CT. AJNR Am J Neuroradiol 36:355–360

    Article  CAS  Google Scholar 

  22. Abdel Razek AA et al (2011) Differentiation between benign and malignant orbital tumors at 3-T diffusion MR imaging. Neuroradiology 53(7):517–522

    Article  Google Scholar 

  23. Sepahdari AR, Aakalu VK, Setabutr P, Shiehmorteza M, Naheedy JH, Mafee MF (2010) Indeterminate orbital masses: restricted diffusion at MR imaging with echo-planar diffusion-weighted imaging predicts malignancy. Radiology 256(2):554–564

    Article  Google Scholar 

  24. Abdel Razek AA et al (2012) Correlation of apparent diffusion coefficient at 3T with prognostic parameters of retinoblastoma. Am J Neuroradiol 33(5):944–948

    Article  CAS  Google Scholar 

  25. de Graaf P, Pouwels PJW, Rodjan F, Moll AC, Imhof SM, Knol DL, Sanchez E, van der Valk P, Castelijns JA (2012) Single-shot turbo spin-echo diffusion-weighted imaging for retinoblastoma: initial experience. Am J Neuroradiol 33(1):110–118

    Article  Google Scholar 

  26. Cui Y, Luo R, Wang R, Liu H, Zhang C, Zhang Z, Wang D (2018) Correlation between conventional MR imaging combined with diffusion-weighted imaging and histopathologic findings in eyes primarily enucleated for advanced retinoblastoma: a retrospective study. Eur Radiol 28(2):620–629

    Article  Google Scholar 

  27. Chen S, Ji X, Liu M, Xia Z, Zheng H, Yin Q, Wang H, Li Y (2017) The value of MRI in evaluating the efficacy and complications with the treatment of intra-arterial chemotherapy for retinoblastoma. Oncotarget 8(24):38413–38425

    PubMed  PubMed Central  Google Scholar 

  28. Sepahdari AR, Kapur R, Aakalu VK, Villablanca JP, Mafee MF (2012) Diffusion-weighted imaging of malignant ocular masses: initial results and directions for further study. AJNR Am J Neuroradiol 33:314–319

    Article  CAS  Google Scholar 

  29. Galluzzi P (2018) Potential value of apparent diffusion coefficient (ADC) in first-line treatment of retinoblastoma. EC Ophthalmology 3:109–118

    Google Scholar 

  30. Xian J, Zhang Z, Wang Z, Li J, Yang B, Man F, Chang Q, Zhang Y (2010) Value of MR imaging in the differentiation of benign and malignant orbital tumors in adults. Eur Radiol 20(7):1692–1702

    Article  Google Scholar 

  31. Xu XQ, Qian W, Ma G, Hu H, Su GY, Liu H, Shi HB, Wu FY (2017) Combined diffusion-weighted imaging and dynamic contrast-enhanced MRI for differentiating radiologically indeterminate malignant from benign orbital masses. Clin Radiol 72(10):903.e9–903.90

    Article  Google Scholar 

  32. Ro SR, Asbach P, Siebert E et al (2016) Characterization of orbital masses by multiparametric MRI. Eur J Radiol 85(2):324–336

    Article  Google Scholar 

  33. Sun B, Song L, Wang X, Li J, Xian J, Wang F, Tan P (2017) Lymphoma and inflammation in the orbit: diagnostic performance with diffusion-weighted imaging and dynamic contrast-enhanced MRI. J Magn Reson Imaging 45:1438–1445

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. NeuroImaging and NeuroInterventional Unit, Azienda Ospedaliera e Universitaria, Senese, Siena, Italy

    Paolo Galluzzi & Alfonso Cerase

  2. Radiology Unit, University of Siena, Siena, Italy

    Tommaso Casseri

  3. Pediatric Unit, Azienda Ospedaliera e Universitaria Senese, Siena, Italy

    Daria Guglielmucci

  4. Department of Pathology, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Paolo Toti

  5. Department of Ophthalmology, Referral Center for Retinoblastoma, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Thedora Hadjistilianou

Authors
  1. Paolo Galluzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tommaso Casseri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alfonso Cerase
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daria Guglielmucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paolo Toti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thedora Hadjistilianou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Galluzzi.

Ethics declarations

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Galluzzi, P., Casseri, T., Cerase, A. et al. Conventional, diffusion, and permeability MR findings in ocular medulloepithelioma. Neuroradiology 60, 1213–1222 (2018). https://doi.org/10.1007/s00234-018-2094-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-018-2094-1

Keywords

Search

Navigation