multinodular and vacuolating neuronal tumor

Multinodular and Vacuolating Neuronal Tumor (MVNT): A Rare Benign Brain Lesion

Multinodular and vacuolating neuronal tumor (MVNT) is a rare benign brain lesion that is commonly found in middle-aged adults [1]. It is characterized by distinct cytoarchitectural patterns, which are often considered part of the spectrum of glial-neuronal lesions [3].

Key Features:

• Benign nature: MVNT is a non-cancerous tumor that does not spread to other parts of the body [4].
• Rare occurrence: MVNT is a rare lesion, with only a few reported cases in medical literature [5].
• Middle-aged adults: The majority of patients diagnosed with MVNT are middle-aged adults [1].
• Epileptogenic: MVNT can cause seizures due to its location and structure [6].

Clinical Presentation:

Patients with MVNT may experience debilitating neurologic complaints, such as seizures, headaches, or cognitive decline [9]. However, the symptoms can vary depending on the tumor's location and size.

References:

• [1] Arbuiso, S. (2021). Multinodular and vacuolating neuronal tumor: A rare benign brain lesion.
• [3] Wang, Z. (2024). Multinodular and vacuolar neuronal tumor: A rare and benign neuroepithelial tumor.
• [4] Elias, P. S. (2020). Multinodular and vacuolating neuronal tumor: A rare, epileptogenic lesion.
• [5] Biyikli, E. (2023). Multinodular and vacuolating neuronal tumor: A recently described lesion with distinct cytoarchitectural patterns.
• [6] Nunes, R. H. (2017). Multinodular and vacuolating neuronal tumor of the cerebrum: A benign, mixed glial-neuronal lesion.
• [9] Huang, H. (2019). Three cases of patients with debilitating neurologic complaints and subsequent diagnosis of MVNT.

Based on the provided context, here are the signs and symptoms associated with multinodular and vacuolating neuronal tumors (MVNT):

• Headache: This is one of the most common complaints among patients with MVNT, reported in [2] and [6].
• Seizures: Seizure activity is a significant symptom of MVNT, with reports indicating that it is the most common manifestation ([9], [5]).
• Stroke-like symptoms: Some patients may experience stroke-like symptoms, such as numbness or weakness on one side of the body ([3], [4]).
• Dizziness and episodic confusion: These symptoms have also been reported in some cases ([9], [7]).
• Absence seizures: A specific type of seizure, absence seizures, has been documented in a patient with MVNT ([5]).

It's worth noting that not all patients with MVNT will exhibit these symptoms, and the severity of the symptoms can vary from person to person. Additionally, some patients may be asymptomatic, meaning they do not show any noticeable signs or symptoms ([9]).

Based on the provided context, it appears that diagnostic tests for multinodular and vacuolating neuronal tumors (MVNTs) are primarily focused on imaging modalities.

• MRI is the primary imaging modality for diagnosing MVNTs [5][6]. Characteristic MRI findings include clusters of nodules with hyperintensity seen in certain regions [3].
• Advanced MRI features have been reported in recent studies, but conventional MRI remains the primary tool for diagnosis [4].
• CT scans may show small bubbly appearing indolent subcortical tumors, although these can be difficult to identify [9].

It's worth noting that while imaging modalities are crucial for diagnosing MVNTs, histological examination is also essential. Histology reveals dysplastic mitotically inactive neuronal tumor cells with tumor cell or matrix vacuolation [14]. However, alterations in MAPK signaling, which are shared with other glioneuronal tumors, are not mandatory for diagnosis.

In terms of specific diagnostic tests, the context does not provide detailed information on biomarkers or genetic testing. However, it mentions that certain markers/tests may be useful in discriminating MVNTs from other lesions [2]. Further research would be necessary to identify these specific tests and their utility in clinical practice.

References: [3] S Arbuiso · 2021 · Cited by 5 [4] S Kishi · 2023 · Cited by 3 [5] Ş Törenek · 2024 [9] by E Biyikli · 2023 · Cited by 5

Treatment Options for Multinodular and Vacuolating Neuronal Tumor (MVNT)

Multinodular and vacuolating neuronal tumors (MVNTs) are rare benign brain lesions that can be challenging to treat. While there is no standard treatment protocol, various management options have been explored.

Antiepileptic Drugs

One of the primary goals in treating MVNT is to manage seizures, which are a common symptom associated with this condition. Antiepileptic drugs (AEDs) such as Riluzole 50 mg [7] have been used to control seizures in patients with MVNT.

Surgery

In some cases, surgical intervention may be necessary to remove the tumor or alleviate symptoms. However, surgery is typically reserved for patients who are symptomatic and do not respond to AEDs [13].

Adjuvant Therapy

With confirmed pathology, adjuvant therapy may not be necessary given the benign course of this tumor [4]. This suggests that in many cases, MVNTs can be managed conservatively without the need for additional treatment.

Therapeutic Management

The therapeutic management of MVNT involves a multidisciplinary approach, including neurologists, neurosurgeons, and radiologists. Treatment decisions are typically made on a case-by-case basis, taking into account the patient's symptoms, tumor size, location, and overall health [13].

In conclusion, while there is no single "best" treatment for MVNT, antiepileptic drugs, surgery, and conservative management are all viable options depending on the individual patient's needs.

References:

[4] by PS Elias · 2020 · Cited by 1 [7] by I Bodi · 2014 · Cited by 54 [13] by Z Wang · 2024 · Cited by 1

Differential Diagnoses for Multinodular and Vacuolating Neuronal Tumor (MVNT)

The differential diagnosis for MVNT includes several conditions that may present with similar radiological findings. Some of the key differential diagnoses are:

• Dysembryoplastic Neuroepithelial Tumor (DNET): This is a rare benign brain tumor that can be difficult to distinguish from MVNT on imaging studies [1][2].
• Focal Cortical Dysplasia (FCD): FCD is a congenital abnormality of the cerebral cortex that can present with similar radiological features as MVNT, including cortical thickening and nodular enhancement [3][4].
• Low-Grade Glioma: Low-grade gliomas are slow-growing tumors that can be difficult to distinguish from MVNT on imaging studies. They often present with cortical thickening and nodular enhancement [5][6].
• Dilated Perivascular Spaces (PVS): PVS is a benign condition characterized by dilated perivascular spaces in the brain. It can be mistaken for MVNT on imaging studies, particularly when it presents with similar radiological features such as cortical thickening and nodular enhancement [7][8].
• Hamartoma: Hamartomas are rare, benign tumors that can occur in various parts of the body, including the brain. They can present with similar radiological features as MVNT, making them a differential diagnosis [9].

It's worth noting that the differential diagnosis for MVNT is not exhaustive and other conditions may also be considered.

References:

[1] Arbuiso et al. (2021) - Multinodular and vacuolating neuronal tumor: A rare benign brain lesion [2] [2] Zahra et al. (2018) - Multinodular and Vacuolating Neuronal Tumor (MVNT) of the cerebrum: A benign lesion described recently in the WHO CNS tumours in 2016 [4] [3] Biyikli et al. (2023) - The differential diagnosis of this lesion should include dysembryoplastic neuroepithelial tumor (DNET), enlarged periventricular space (PVS) and ... [7] [4] Elias et al. (2020) - Multinodular and vacuolating neuronal tumor is a rare lesion often associated with seizure activity. Surgical management gives a pathologic diagnosis and may ... [8] [5] Bodi et al. (2014) - MVNT was reported as a lesion associated with adult onset seizures. Of the ten cases reported by Huse et al., five cases had adult onset ... [9] [6] Alizada et al. (2020) - Focal cortical dysplasia (FCD) and low grade glioma (LGG) must take into consideration as differential diagnosis. [10]