Thalamic rosette-forming glioneuronal tumor stable for more than 11 years after subtotal removal: Case report and review of literature

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  • 亜全摘出後11年以上再発なく経過している視床発生のロゼット形成性グリア神経細胞腫瘍 : 症例報告と文献レビュー

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BACKGROUND: Rosette-forming glioneuronal tumors (RGNTs) are rare and slow-growing (WHO grade 1); they mainly involve the posterior fossa. We here report a rare RGNT originating from the thalamus; after subtotal removal it remained stable for more than 11 years. CASE PRESENTATION: A woman in her early 20s consulted us due to a 6-month history of memory difficulties, headaches, and blurred vision. Magnetic resonance imaging (MRI) showed obstructive hydrocephalus and an 18-mm non-cystic third ventricular tumor that arose at the right thalamus. It was isointense on T1-wighted images, highintense on T2-weighted images, and non-enhances T1-weighted images. Through a right trans-ventricular subchoroidal approach we made subtotal resection of the soft tumor, leaving a small remnant attached to the posterior thalamic wall. Histologically, the tumor was composed of an alveolar component that included rosettes surrounding cores of eosinophilic neuropils or small vessels and a solid component resembling pilocytic astrocytoma. The cells composing the rosettes were positive for olig-2, MAP, and synaptophysin. The Ki-67 index was around 1%. Postoperatively her symptoms disappeared, and she commenced her engineering career. MRI performed 11.3 years after the surgery found the absence of recurrence. CONCLUSION: This RGNT is quite unique because it arose from the thalamus, very rare site from which RGNTs originate, and remained stable for more than 11 years after subtotal resection.

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