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Surgery for epilepsy in children with dysembryoplastic neuroepithelial tumor: clinical spectrum, seizure outcome, neuroradiology, and pathology

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Abstract

Introduction

Dysembryoplastic neuroepithelial tumors (DNTs) were first described by Daumas-Duport et al. in 1988 as a typically cortical tumor affecting young patients with long-standing, drug-resistant epilepsy.

Methods

We reviewed the medical records of 29 patients with DNT between 1994 and 2007 at Hacettepe University Children’s Hospital retrospectively; age at the time of surgery, age at seizure onset, electroencephalography (EEG), MRI, medical treatment, surgical procedure, seizure outcome, and pathological findings were documented.

Results

Male to female ratio was 15/14. Age at the time of evaluation ranged 4–24 years. Twenty-seven patients (93.1%) had complex partial seizures, one (3.44%) had simple partial seizures, and one patient had generalized seizures. Preop interictal EEG showed epileptiform discharges in 24 patients, while in five patients interictal EEG before surgery showed no epileptiform discharges. Pathologically, 24 of our patients were classified as complex type and five as simple type. MRI showed temporal lesion in 20 (68.9%) patients and nine patients had extratemporal DNT. We choose the type of surgery according to lesion and the epileptojenic zone. Finally, 27 patients had Engel Class IA and two patients had Engel Class IB outcome.

Conclusion

Complete resection of the lesion with epileptojenic zone is important for seizure-free outcome. Timing of surgery, extent of surgery, and stopping antiepileptic drugs are still important factors.

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References

  1. Aronica E, Leenstra S, van Veelen CW, van Rijen PC, Hulsebos TJ, Tersmette AC, Yankaya B, Troost D (2001) Glioneuronal tumors and medically intractable epilepsy: a clinical study with long-term follow-up of seizure outcome after surgery. Epilepsy Res 43(3):179–191

    Article  CAS  PubMed  Google Scholar 

  2. Chan CH, Bittar RG, Davis GA, Kalnins RM, Fabinyi GCA (2006) Long-term seizure outcome following surgery for dysembryoplastic neuroepithelial tumor. J Neurosurg 104:62–69

    Article  PubMed  Google Scholar 

  3. Daumas-Duport C, Scheithauer BW, Chodkiewicz JP, Laws Jr ER, Vedrenne C (1988) Dysembryoplastic neuroepithelial tumor: a surgically curable tumor of young patients with intractable seizures. Neurosurgery 23:545–556

    Article  CAS  PubMed  Google Scholar 

  4. Daumas-Duport C, Varlet P, Bacha S, Beuvon F, Cervera-Pierot P, Chodkiewics JP (1999) Dysembryoplastic neuroepithelial tumors: nonspecific histological forms: a study of 40 cases. J Neurooncol 41:267–280

    Article  CAS  PubMed  Google Scholar 

  5. Fernandez C, Girard N, Paz Paredes A, Bouvier-Labit C, Lena G, Figarella-Branger D (2003) The usefulness of MR imaging in the diagnosis of dysembryoplastic neuroepithelial tumor in children: a study of 14 cases. Am J Neuroradiol 24:829–834

    PubMed  Google Scholar 

  6. Gottschalk J, Korves M, Skotzek-Konrad B, Goebel S, Cervos-Navarro J (1993) Dysembryoplastic neuroepithelial micro-tumor in a 75-year-old patient with long-standing epilepsy. Clin Neuropathol 12:175–178

    CAS  PubMed  Google Scholar 

  7. Hamada H, Kurimoto M, Nagai S, Asahi T, Hirashima Y, Endo S (2003) A rare case of dysembryoplastic neuroepithelial tumour in occipital lobe presenting with only headache. J Clin Neurosci 10(2):276–278

    Article  PubMed  Google Scholar 

  8. Hammond RR, Duggal N, Woulfe JMJ, Girvin JP (2000) Malignant transformation of a dysembryoplastic neuroepithelial tumor. Case report. J Neurosurg 92:722–725

    Article  CAS  PubMed  Google Scholar 

  9. Hennessy MJ, Elwes RD, Binnie CD, Polkey CE (2000) Failed surgery for epilepsy. A study of persistence and recurrence of seizures following temporal resection. Brain 123:2445–2466

    Article  PubMed  Google Scholar 

  10. Honavar M, Janota I, Polkey CE (1999) Histological heterogeneity of dysembryoplastic neuroepithelial tumour: identification and differential diagnosis in a series of 74 cases. Histopathology 34(4):342–356

    Article  CAS  PubMed  Google Scholar 

  11. Kirkpatrick PJ, Honavar M, Janota I, Polkey CE (1993) Control of temporal lobe epilepsy following en bloc resection of low-grade tumors. J Neurosurg 78:19–25

    Article  CAS  PubMed  Google Scholar 

  12. Lee DY, Chung CK, Hwang YS, Choe G, Chi JG, Kim HJ, Cho BK (2000) Dysembryoplastic neuroepithelial tumor: radiological findings (including PET, SPECT, and MRS) and surgical strategy. J Neurooncol 47(2):167–174

    Article  CAS  PubMed  Google Scholar 

  13. Lowe AJ, David E, Kilpatrick CJ, Matkovic Z, Cook MJ, Kaye A, O'Brien TJ (2004) Epilepsy surgery for pathologically proven hippocampal sclerosis provides long-term seizure control and improved quality of life. Epilepsia 45(3):237–242

    Article  PubMed  Google Scholar 

  14. Luyken C, Blümcke I, Fimmers R, Urbach H, Elger CE, Wiestler OD, Schramm J (2003) The spectrum of long-term epilepsy-associated tumors: long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia 44(6):822–830

    Article  PubMed  Google Scholar 

  15. McIntosh AM, Wilson SJ, Berkovic SF (2001) Seizure outcome after temporal lobectomy: current research practice and findings. Epilepsia 42(10):1288–1307

    Article  CAS  PubMed  Google Scholar 

  16. Minkin K, Klein O, Mancini J, Lena G (2008) Surgical strategies and seizure control in pediatric patients with dysembryoplastic neuroepithelial tumors: a single-institution experience. J Neurosurg Pediatrics 1:206–210

    Article  Google Scholar 

  17. Nolan MA, Sakuta R, Chuang N, Otsubo H, Rutka JT, Snead OC 3rd, Hawkins CE, Weiss SK (2004) Dysembryoplastic neuroepithelial tumors in childhood: long-term outcome and prognostic features. Neurology 62:2270–2276

    CAS  PubMed  Google Scholar 

  18. Prayson RA, Estes ML, Morris HH (1993) Coexistence of neoplasia and cortical dysplasia in patients presenting with seizures. Epilepsia 34:609–615

    Article  CAS  PubMed  Google Scholar 

  19. Raymond AA, Halpin SF, Alsanjari N, Cook MJ, Kitchen ND, Fish DR, Stevens JM, Harding BN, Scaravilli F, Kendall B, Shorvon SD, Neville BGR (1994) Dysembryoplastic neuroepithelial tumor. Features in 16 patients. Brain 117( Pt 3):461–475

    Article  PubMed  Google Scholar 

  20. Rushing EJ, Thompson LD, Mena H (2003) Malignant transformation of a dysembryoplastic neuroepithelial tumor after radiation and chemotherapy. Ann Diagn Pathol 7:240–244

    Article  PubMed  Google Scholar 

  21. Sandberg DI, Ragheb J, Dunoyer C, Bhati S, Olavarria G, Morrison G (2005) Surgical outcomes and seizure control rates after resection of dysembryoplastic neuroepithelial tumors. Neurosurg Focus 18(6A):E5

    PubMed  Google Scholar 

  22. Takahashi A, Hong SC, Seo DW, Hong SB, Lee M, Suh YL (2005) Frequent association of cortical dysplasia in dysembryoplastic neuroepithelial tumor treated by epilepsy surgery. Surg Neurol 64:419–427

    Article  PubMed  Google Scholar 

  23. Thom M, Gomez-Anson B, Revesz T, Harkness W, O'Brien CJ, Kett-White R, Jones EW, Stevens J, Scaravilli F (1999) Spontaneous intralesional haemorrhage in dysembryoplastic neuroepithelial tumours: a series of five cases. J Neurol Neurosurg Psychiatry 67(1):97–101

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Hacettepe University School of Medicine, 06100, Ankara, Turkey

    Burçak Bilginer & Nejat Akalan

  2. Department of Pediatric Neurology, Hacettepe University School of Medicine, Ankara, Turkey

    Dilek Yalnızoglu, Guzide Turanlı & Meral Topçu

  3. Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey

    Figen Soylemezoglu

  4. Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey

    Ayşenur Cila

Authors
  1. Burçak Bilginer
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  2. Dilek Yalnızoglu
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  3. Figen Soylemezoglu
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  4. Guzide Turanlı
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  5. Ayşenur Cila
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  6. Meral Topçu
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  7. Nejat Akalan
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Correspondence to Burçak Bilginer.

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Bilginer, B., Yalnızoglu, D., Soylemezoglu, F. et al. Surgery for epilepsy in children with dysembryoplastic neuroepithelial tumor: clinical spectrum, seizure outcome, neuroradiology, and pathology. Childs Nerv Syst 25, 485–491 (2009). https://doi.org/10.1007/s00381-008-0762-x

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  • DOI: https://doi.org/10.1007/s00381-008-0762-x

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