DNET (Dysembryoplastic neuroepithelial tumor)

FACTS

  • WHO Grade I glioma, considered benign
  • usually cortically based in temporal lobe of children / young adults
  • 1-5% of all primary brain tumors
  • represent about 1/5 of DRE
 

HPI

universal ROS
  • detailed seizure history

PHYSICAL EXAM

universal exam

IMAGING

CT:
  • hypodense w/ obvious margins
MRI:
  • T1: hypo, T2 hyper, T1+c: rare (nodular if present)
A/P
  • Seizure control medically
  • Generally need to operate on these if symptomatic, the sooner the better
  • counsel
    • seizure control usually improves after GTR
    • more time spent with intractable seizures (before surgery) lowers this chance, however
    • recurrence is rare
    • even tumor growth after partial resection is rare
 

Examples

Young adult with a left hand-knob DNET

Coronal and axial T1 images showing hypo-dense left hand-knob lesion (top) with no edema on T2 FLAIR (bottom lef) nor enhancing (bottom right)
Coronal and axial T1 images showing hypo-dense left hand-knob lesion (top) with no edema on T2 FLAIR (bottom lef) nor enhancing (bottom right)