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DNET/Ganglioglioma – Epilepsy-Associated Tumour — SCE Neurology MCQ

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ModerateNeuro-oncologyDNET/Ganglioglioma – Epilepsy-Associated TumourSCE Neurology

A 25-year-old man presents with his first focal seizure arising from the right temporal lobe. MRI brain shows a well-circumscribed lesion in the right temporal lobe with mixed signal, including areas of calcification, cystic components, and a 'bubbly' appearance without significant oedema or mass effect. It does not enhance with gadolinium. What is the most likely underlying tumour?

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Correct answer: D — Ganglioglioma or dysembryoplastic neuroepithelial tumour (DNET)

Low-grade developmental tumours (gangliogliomas and DNETs) are the most common tumour-related causes of chronic temporal lobe epilepsy in young adults. They are typically well-circumscribed, cortically based, with mixed signal (cystic and solid components), calcification, and minimal or no enhancement. DNETs characteristically have a 'bubbly' multinodular appearance. Both are WHO grade 1 and surgical resection is often curative for both the tumour and the epilepsy. A: GBM has ring enhancement and necrosis. C: Meningiomas are extra-axial. D: Metastases have surrounding oedema and enhancement. E: Lymphoma enhances homogeneously.

Reference: NICE NG99 Brain Tumours (2021); WHO CNS Tumour Classification (2021)