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Supratentorial Primitive Neuroectodermal Tumor in an Adult

Ali Cengiz*, Hasan Erdogan, Vefa Oner and Arzu Cengiz



Department of Radiology, Konya Education and Research Hospital, University of Health Sciences, Turkey


*Corresponding author: Ali Cengiz, Assistant, Department of Radiology, Education and Research Hospital, University of Health Sciences, Turkey, Tel: +90 332 221 0000, E-mail: alicengiz7158@gmail.com
Clin Med Img Lib, CMIL-2-044, (Volume 2, Issue 5); ISSN: 2474-3682
Published Date: May 17, 2016
Citation: Cengiz A, Erdogan H, Oner V, Cengiz A (2016) Supratentorial Primitive Neuroectodermal Tumor in an Adult. Clin Med Img Lib 2:044.
Copyright: © 2016 Cengiz A, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



A 53-year-old man admitted to our emergency service with symptoms of intermittent vomiting and headache for a week. In the hospital the patient swiftly deteriorated to coma. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain were performed. CT imaging showed a large intra-axial cystic tumour with solid component in the right frontal lobe with diffuse perilesional vasogenic edema. MRI scan showed a large frontal cystic mass with mass effect upon the right ventricle and leftward midline shift approximately 12 mm. In contrast MRI imaging, heterogeneous enhancement in the solid component of tumour was noted. He underwent biopsy of the lesion and verified the diagnosis of Primitive Neuroectodermal Tumor (PNET) (Figure 1).

PNET is malignant, embryoblastic small cell neoplasm of childhood thought to results from primitive and undifferentiated neuroepithelial cells. PNET is extremely rare in adults. PNET may appears any location. The supratentorial PNET is most commonly in the temporo-parietal region. On MRI imaging typically occurs a large, lobulated, sharp-demarcated mass with heterogeneous signal T1 and T2 weighted images. It may have cystic, hemorrhagic and calcific component. The differential diagnozis of supratentorial PNET should involve glioblastoma multiforme, anaplastic oligodendroglioma, gangliocytoma and metastasis (Figure 2) [1-4]



Figure 1: Computed Tomography (CT) scans: Axial and koronal non-enhanced CT images showing a large, well demarcated cystic mass with a solid component (arrow) in the right frontal lobe.



Figure 2: Magnetic Resonance Image (MRI):
A) Axial non-contrast T2 weighted images showing a large heterogeneous cystic mass with severe perilesional edema and compressing the ipsilateral lateral ventricle; B) Coronal post-contrast T1 weighted; C) Axial subtraction images showing enhancement of solid component.




References
  1. Kim, Dong Gyu, Paek SH, Chi JG, Choe G, et al. (2002) Supratentorial primitive neuroectodermal tumors in adults. J Neurooncol 60: 43-52.

  2. Peterson K, Russell W Walker (1995) Medulloblastoma/primitive neuroectodermal tumor in 45 adults. Neurology 45: 440-442.

  3. Smoll, NR, Katharine J Drummond (2012) The incidence of medulloblastomas and primitive neurectodermal tumours in adults and children. J Clin Neurosci 19: 1541-1544.

  4. Pickuth D, U Leutloff (1996) Computed tomography and magnetic resonance imaging findings in primitive neuroectodermal tumours in adults. Br J Radiol 69: 1-5.


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