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Published in: Child's Nervous System 7/2007

01-07-2007 | Case-based Update

Lhermitte–Duclos disease

Authors: Raj Kumar, Vivek Kumar Vaid, Samir Kumar Kalra

Published in: Child's Nervous System | Issue 7/2007

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Abstract

Background

Lhermitte–Duclos disease (LDD; dysplastic gangliocytoma of the cerebellum) is a rare hamartoma of the cerebellum. It was first described by Lhermitte and Duclos in 1920 as “Sur un ganglioneurome diffus du cortex du cervelet” (Lhermitte and Duclos [Bull Assoc Fr Etude Cancer 9:99–107, 1920]). Since then, due to its rarity and the variability of its presentation, the diagnosis is often missed. It is not only important for the neurosurgeon and the pathologist to be aware of this entity so as to differentiate from malignant lesions but also to distinguish it from other cerebellar malformations, which may be hypoplastic or dysplastic, focal or diffuse in nature, with brain stem and cerebral involvement, and varied natural course.

Illustrative case

We report a case of LDD in a 16-year-old boy. This case exemplifies the rarity of the disease leading to lack of awareness with which the diagnosis was easily missed. We also take this opportunity to discuss the clinical presentation, neuroradiological appearance, and a brief summary of histopathological findings, pathogenetic considerations, and neurogenetical aspects.
Literature
1.
go back to reference Ambler M, Pogacar S, Sidman R (1969) Lhermitte–Duclos disease (granule cell hypertrophy of the cerebellum): pathological analysis of the first familial cases. J Neuropathol Exp Neurol 28:622–647PubMed Ambler M, Pogacar S, Sidman R (1969) Lhermitte–Duclos disease (granule cell hypertrophy of the cerebellum): pathological analysis of the first familial cases. J Neuropathol Exp Neurol 28:622–647PubMed
2.
go back to reference Asley DG, Chi-Shing Z, Chandrasoma PT, Segall HD (1990) Lhermitte–Duclos disease: CT and MRI findings. J Comput Assist Tomogr 14:984–987CrossRef Asley DG, Chi-Shing Z, Chandrasoma PT, Segall HD (1990) Lhermitte–Duclos disease: CT and MRI findings. J Comput Assist Tomogr 14:984–987CrossRef
3.
go back to reference Beuche W, Wickbold J, Friede RL (1983) Lhermitte–Duclos disease—its minimal lesion in microscopic data and CT findings. Clin Neuropathol 2:163–170PubMed Beuche W, Wickbold J, Friede RL (1983) Lhermitte–Duclos disease—its minimal lesion in microscopic data and CT findings. Clin Neuropathol 2:163–170PubMed
4.
go back to reference Brown WR, Angelo JN, Kelly DL (1980) Lhermitte–Duclos disease: case report with computerized tomographic scan. Neurosurgery 6:189–191PubMedCrossRef Brown WR, Angelo JN, Kelly DL (1980) Lhermitte–Duclos disease: case report with computerized tomographic scan. Neurosurgery 6:189–191PubMedCrossRef
5.
go back to reference Carter J, Merren M, Swann K (1989) Preoperative diagnosis of Lhermitte–Duclos disease by magnetic resonance imaging: case report. J Neurosurg 70:135–137PubMed Carter J, Merren M, Swann K (1989) Preoperative diagnosis of Lhermitte–Duclos disease by magnetic resonance imaging: case report. J Neurosurg 70:135–137PubMed
6.
go back to reference Derrey S, Proust F, Debono B, Langlois O, Layet A, Layet V, Longy M, Freger P, Laquerriere A (2004) Association between Cowden syndrome and Lhermitte–Duclos disease. Report of two cases and review of the literature. Surg Neurol 61(5):447–454PubMedCrossRef Derrey S, Proust F, Debono B, Langlois O, Layet A, Layet V, Longy M, Freger P, Laquerriere A (2004) Association between Cowden syndrome and Lhermitte–Duclos disease. Report of two cases and review of the literature. Surg Neurol 61(5):447–454PubMedCrossRef
7.
go back to reference Kulkantrakorn K, Awward EE, Levy B, Selhorst JB, Cole HO, Leake D, Gussler JR, Epstein AD, Malik MM (1997) MRI in Lhermitte–Duclos disease. Neurolgy 48:725–731 Kulkantrakorn K, Awward EE, Levy B, Selhorst JB, Cole HO, Leake D, Gussler JR, Epstein AD, Malik MM (1997) MRI in Lhermitte–Duclos disease. Neurolgy 48:725–731
8.
go back to reference Lhermitte J, Duclos P (1920) Sur un ganglionneurome diffus du cortex du cervelet. Bull Assoc Fr Etude Cancer 9:99–107 Lhermitte J, Duclos P (1920) Sur un ganglionneurome diffus du cortex du cervelet. Bull Assoc Fr Etude Cancer 9:99–107
9.
go back to reference Meltzer CC, Smirniotopolous JG, Jones RV (1995) The striated cerebellum: an MR imaging sign in Lhermitte–Duclos disease (dysplastic gangliocytoma). Radiology 194:699–703PubMed Meltzer CC, Smirniotopolous JG, Jones RV (1995) The striated cerebellum: an MR imaging sign in Lhermitte–Duclos disease (dysplastic gangliocytoma). Radiology 194:699–703PubMed
10.
go back to reference Marano R, Johnson PC, Spetzler RF (1988) Recurrent Lhermitte–Duclos disease in a child. Case report. J Neurosurg 69:599–603PubMed Marano R, Johnson PC, Spetzler RF (1988) Recurrent Lhermitte–Duclos disease in a child. Case report. J Neurosurg 69:599–603PubMed
11.
go back to reference Nelen MR, Kremer H, Konings IB, Schoute F, van Essen AJ, Koch R, Woods CG, Fryns JP, Hamel B, Hoefsloot LH, Peeters EA, Padberg GW (1999) Novel PTEN mutations in patients with Cowden disease: absence of clear genotype–phenotype correlations. Eur J Hum Genet 7:267–273PubMedCrossRef Nelen MR, Kremer H, Konings IB, Schoute F, van Essen AJ, Koch R, Woods CG, Fryns JP, Hamel B, Hoefsloot LH, Peeters EA, Padberg GW (1999) Novel PTEN mutations in patients with Cowden disease: absence of clear genotype–phenotype correlations. Eur J Hum Genet 7:267–273PubMedCrossRef
12.
go back to reference Nowak DA, Trost HA, Porr A, Stolzle A, Lumenta CB (2001) Lhemitte–Duclos disease (dysplastic gangliocytoma of the cerebellum). Clin Neurol Neurosurg 103:105–110PubMedCrossRef Nowak DA, Trost HA, Porr A, Stolzle A, Lumenta CB (2001) Lhemitte–Duclos disease (dysplastic gangliocytoma of the cerebellum). Clin Neurol Neurosurg 103:105–110PubMedCrossRef
13.
go back to reference Oppenheimer DR (1955) A benign ‘tumor’ of the cerebellum. Report on two cases of diffuse hypertrophy of the cerebellar cortex with a review of nine previously reported cases. J Neurol Neurosurg Psychiatry 18:199–213PubMed Oppenheimer DR (1955) A benign ‘tumor’ of the cerebellum. Report on two cases of diffuse hypertrophy of the cerebellar cortex with a review of nine previously reported cases. J Neurol Neurosurg Psychiatry 18:199–213PubMed
14.
go back to reference Padma MV, Jacobs M, Sequeira P, Adineh M, Satter M, Kraus G, Mantil JC (2004) Functional imaging in Lhermitte Duclos disease. Mol Imaging Biol 6(5):319–323 (Sep–Oct)PubMedCrossRef Padma MV, Jacobs M, Sequeira P, Adineh M, Satter M, Kraus G, Mantil JC (2004) Functional imaging in Lhermitte Duclos disease. Mol Imaging Biol 6(5):319–323 (Sep–Oct)PubMedCrossRef
15.
go back to reference Patel S, Barkovich AJ (2002) Analysis and classification of cerebellar malformations. Am J Neuroradiol 23:1074–1087PubMed Patel S, Barkovich AJ (2002) Analysis and classification of cerebellar malformations. Am J Neuroradiol 23:1074–1087PubMed
16.
go back to reference Reznik M, Schoenen J (1983) Lhermitte–Duclos disease. Acta Neuropathol (Berl) 53:88–94CrossRef Reznik M, Schoenen J (1983) Lhermitte–Duclos disease. Acta Neuropathol (Berl) 53:88–94CrossRef
17.
go back to reference Robinson S, Cohen AR (2000) Cowden disease and Lhermitte–Duclos disease: characterization of a new phakomatosis. Neurosurgery 46:371–383PubMedCrossRef Robinson S, Cohen AR (2000) Cowden disease and Lhermitte–Duclos disease: characterization of a new phakomatosis. Neurosurgery 46:371–383PubMedCrossRef
18.
go back to reference Roski RA, Roessmann U, Spetzler RF, Kaufman B, Nulsen F (1981) Clinical and pathological study of dysplastic gangliocytoma. J Neurosurg 55:318–321PubMedCrossRef Roski RA, Roessmann U, Spetzler RF, Kaufman B, Nulsen F (1981) Clinical and pathological study of dysplastic gangliocytoma. J Neurosurg 55:318–321PubMedCrossRef
19.
go back to reference Shanley DJ, Vassalo CJ (1992) Atypical presentation of Lhermitte Duclos disease: preoperative diagnosis with MRI. Neuroradiology 34:103–105PubMedCrossRef Shanley DJ, Vassalo CJ (1992) Atypical presentation of Lhermitte Duclos disease: preoperative diagnosis with MRI. Neuroradiology 34:103–105PubMedCrossRef
20.
go back to reference Shiurba RA, Gessaga EC, Eng LF, Sternberger LA, Sternberger NH, Urich H (1988) Lhermitte–Duclos disease. Acta Neuropathol (Berl) 75:474–480CrossRef Shiurba RA, Gessaga EC, Eng LF, Sternberger LA, Sternberger NH, Urich H (1988) Lhermitte–Duclos disease. Acta Neuropathol (Berl) 75:474–480CrossRef
21.
go back to reference Smith R, Grossman R, Goldberg H, Hackney D, Bilaniuk L, Zimmerman R (1989) MR imaging of Lhermitte–Duclos disease. A case report. Am J Neuroradiol 10:187–189PubMed Smith R, Grossman R, Goldberg H, Hackney D, Bilaniuk L, Zimmerman R (1989) MR imaging of Lhermitte–Duclos disease. A case report. Am J Neuroradiol 10:187–189PubMed
22.
go back to reference Stapleton SR, Wilkins PR, Bell BA (1992) Recurrent dysplastic cerebellar gangliocytoma (Lhermitte–Duclos disease) presenting with subarachnoid haemorrhage. Br J Neurosurg 6:153–156PubMed Stapleton SR, Wilkins PR, Bell BA (1992) Recurrent dysplastic cerebellar gangliocytoma (Lhermitte–Duclos disease) presenting with subarachnoid haemorrhage. Br J Neurosurg 6:153–156PubMed
23.
go back to reference Sutphen R, Diamond TM, Minton SE, Peacocke M, Tsou HC, Root AW (2000) Severe Lhermitte–Duclos disease with unique germline mutation of PTEN. Am J Med Genet 82:290–293CrossRef Sutphen R, Diamond TM, Minton SE, Peacocke M, Tsou HC, Root AW (2000) Severe Lhermitte–Duclos disease with unique germline mutation of PTEN. Am J Med Genet 82:290–293CrossRef
24.
go back to reference Vinchon M, Blond S, Lejune JP, Krivosik I, Fossati P, Assaker R, Christiaens JL (1994) Association of Lhermitte–Duclos and Cowden disease: report of a new case and review of the literature. J Neurol Neurosurg Psychiatry 57:699–704PubMedCrossRef Vinchon M, Blond S, Lejune JP, Krivosik I, Fossati P, Assaker R, Christiaens JL (1994) Association of Lhermitte–Duclos and Cowden disease: report of a new case and review of the literature. J Neurol Neurosurg Psychiatry 57:699–704PubMedCrossRef
Metadata
Title
Lhermitte–Duclos disease
Authors
Raj Kumar
Vivek Kumar Vaid
Samir Kumar Kalra
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 7/2007
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-006-0271-8

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