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Open Access Highly Accessed Case Report

Mixed neuronal-glial tumor in the temporal lobe of an infant: a case report

Hirohito Yano1*, Chiemi Saigoh2, Noriyuki Nakayama1, Yoshinobu Hirose3, Masato Abe4, Naoyuki Ohe1, Michio Ozeki5, Jun Shinoda6 and Toru Iwama1

Author Affiliations

1 Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan

2 Department of Pathology, Gifu University Hospital, Gifu, Japan

3 Department of Pathology, Osaka Medical College, Takatsuki, Japan

4 Department of Diagnostic Pathology, School of Medicine Fujita Health University, Toyoake, Japan

5 Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan

6 Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Minokamo, Japan

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Diagnostic Pathology 2013, 8:164  doi:10.1186/1746-1596-8-164

Published: 2 October 2013

Abstract

Background

Tumors that arise in the temporal lobes of infants and spread to the neural system are limited to several diagnoses. Herein, we present an infantile case of a temporal tumor showing neuronal and glial differentiation.

Case presentation

The patient was a 9-month-old boy with low body weight due to intrauterine growth retardation. At 9 months after birth, he presented partial seizures. Computed tomography scanning revealed a mass (35 * 40 mm) in the left temporal lobe. Isointensity was noted on magnetic resonance T1-weighted images and fluid attenuation inversion recovery images. The tumor was heterogeneously enhanced with gadolinium. Positron emission tomography showed high methionine uptake in the tumor. During surgery, the tumor, which was elastic and soft and bled easily, was gross totally resected. A moderately clear boundary was noted between the tumor and normal brain parenchyma. Histologically, the tumor mainly comprised a ganglioglioma-like portion and short spindle cells at different densities. The former was immunohistochemically positive for some kinds of neuronal markers including synaptophysin. The spindle cells were positive for glial fibrillary acidic protein, but desmoplasia was not observed.

Discussion

The tumor contained both neuronal and glial elements; the former were the main constituents of the tumor and included several ganglion-like cells. Because neuronal elements gradually transited to glial cells, a mixed neuronal-glial tumor was diagnosed.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2045126100982604 webcite

Keywords:
Neuronal tumor; Glioneuronal tumor; Mixed tumor; Temporal tumor; Infant; Epilepsy