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Coexistence of Neoplasia and Cortical Dysplasia in Patients Presenting with Seizures
Authors:Richard A. Prayson  Melinda L. Estes  Harold H. Morris
Affiliation:Departments of Anatomic Pathology, The Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.;Departments of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.
Abstract:Summary: Tumors and cortical dysplasia are associated with epilepsy, but few studies have examined the coexistence of neoplasia and dysplasia in these patients. We studied 13 patients (age 4–29 years) with recurrent seizures of 1 month to 21-year' duration (median 72 months). Ten patients were aged <21 years. Imaging studies localized the lesion to the temporal lobe (10 patients), parietal lobe (2 patients), and frontal lobe (1 patient). Tumors included ganglioglioma (8 patients), dysembryoplastic neuroepithelial tumor (DNT) (3 patients), and low-grade as- trocytoma (2 patients). Cortical dysplasia, including atypical aggregates of neurons (6 patients), multifocal loss of the cortical laminar architecture (7 patients), and neurons in the molecular layer of the cortex (3 patients) were observed near but separate from the tumor. Coexistence of certain tumors with cortical dysplasia, most frequently observed in the pediatric population, suggests a hamar-tomatous/dysplastic nature of the neoplasms.
Keywords:Cortical dysplasia    Neoplasia    Ganglioglioma    Dysembryoplastic neuroepithelial tumor    Low-grade as-trocytoma    Neurologic examination    Child
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