Long-term epilepsy-associated tumors (LEAT)

Case contributed by Nerses Nersesyan
Diagnosis certain

Presentation

Some of the most frequently seen LEATs

Annotated image

PXA: Pleomorphic Xanthoastrocytoma

MVNT: Multinodular and vacuolating neuronal tumors

DNET: Dysembryoplastic neuroepithelial tumor

GG: Ganglioglioma

Case Discussion

GG (Ganglioglioma): This tumor is frequently located in the temporal lobe and is typically seen as a contrast-enhancing nodule associated with a cortical/subcortical cyst. The lesion may show calcifications in 1/3 of the cases.
Most GG are considered WHO grade 1 tumors, while around 5% are considered WHO grade III.

PXA (Pleomorphic Xanthoastrocytoma): Typically, it shows a dural enhancement as a distinguishing feature; however, it may be impossible to distinguish from GG and may even present as a PXA-GG composite lesion.
The tumor can be considered as WHO grade II or III in anaplastic cases.

DNET (Dysembryoplastic neuroepithelial tumor): The multiloculated cysts represent the cortex's glioneural element and can be either oriented in a globoid fashion or perpendicular to the cortical surface. DNET is considered a WHO grade I tumor.

MVNT (Multinodular and vacuolating neuronal tumors): A cluster of micronodules in the cortical-subcortical junction interspersed by normal parenchyma.

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