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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(11): s00451809933
DOI: 10.1055/s-0045-1809933
Neuroimaging

Double calcification in PLNTY: an unusual presentation of a rare tumor in young patients

Diego Jordão Lino Dias 
1   Hospital Beneficência Portuguesa de São Paulo, Divisão de Neurorradiologia, São Paulo SP, Brazil
,
Camilla Akemi Felizardo Yamada 
2   Hospital Beneficência Portuguesa de São Paulo, Divisão de Oncologia Clínica, São Paulo SP, Brazil.
,
Carmen Lucia Penteado Lancellotti 
3   Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo SP, Brazil.
,
Lázaro Luíz Faria do Amaral 
1   Hospital Beneficência Portuguesa de São Paulo, Divisão de Neurorradiologia, São Paulo SP, Brazil
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A 17-year-old, previously healthy, female patient presented with new-onset seizures. Computed tomography and magnetic resonance imaging scans ([Figure 1]) revealed a solid lesion in the right parietal lobe with two densely calcified areas, suggestive of neoplastic characteristics, which was surgically resected for diagnostic clarification. The histopathological and immunohistochemical analyses ([Figure 2]) confirmed the diagnosis of polymorphous low-grade neuroepithelial tumor of the young (PLNTY). Postoperatively, the patient improved clinically and remains disease-free.

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Figure 1 Head computed tomography (CT) scan (A,B) demonstrating a deep, solid, and heterogeneously-calcified parenchymal lesion in the right parietal lobe. Axial susceptibility-weighted imaging (SWI) magnietic resonance imaging (MRI) scan (C,D) showing marked hypointensity due to calcification, with emphasis on a smaller component of this lesion in the cortico-subcortical region of the right superior parietal lobule. Axial fluid-attenuated inversion recovery (FLAIR) MRI scan (E) demonstrating the lesion at two levels, with a predominance of hyperintense signal and hypointense areas in the more densely-calcified regions (blue arrows). A Head CT scan (F), presented in soft tissue and bone windows on the same coronal plane, better characterizes the dual calcification pattern (yellow arrows). Sagittal T1-weighted MRI scan (G) showing the lesion's extension from the cortico-subcortical region to the deep white matter, surrounded by a slight hyperintense halo (red arrows). Venous MR angiography (H) revealing mild enhancement of the lesion with paramagnetic contrast (green arrows).
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Figure 2 (A) Hematoxylin and eosin staining (H&E) showing small, round, oligodendroglioma-like cells with slight nuclear variability. (B) H&E staining revealing dense calcifications within both adjacent tumor and non-tumor components. (C) S100-positive cells, (D) GFAP-positive cells, (E,F) Olig2-positive cells, and (F) CD34-positive cells are an important finding to distinguish from oligodendrogliomas. (G) Preserved ATRX. (H) SYN-negative. (I) IDH-1-negative. (J) Very low Ki-67 index (1–2%). BRAF V600E gene mutations were not found.

The 2021 World Health Organization classification for PLNTY describes features such as oligodendroglioma-like cellular morphology, microcalcifications, low Ki-67 index, and absence of necrosis.[1] The imaging findings and the tumor's location in the right, non-dominant hemisphere, support the diagnosis.[2] [3]

Authors' Contributions

Conceptualization: DJLD, CAFY, CLPL, LLFA; Formal analysis: CAFY, CLPL, LLFA; Investigation: CAFY, CLPL, LLFA; Methodology: DJLD; Supervision: CAFY, CLPL, LLFA; Validation: CAFY, CLPL, LLFA; Visualization: CAFY, CLPL, LLFA; Writing – original draft: DJLD; Writing – review & editing: DJLD, CAFY, CLPL, LLFA.


Data Availability Statement

All data supporting the findings of this study are available within the paper.


Editor-in-Chief: Ayrton Roberto Massaro (https://orcid.org/0000-0002-0487-5299).


Associate Editor: Antonio José da Rocha (https://orcid.org/0000-0003-2591-9171).




Publication History

Received: 04 March 2025

Accepted: 04 May 2025

Article published online:
28 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Diego Jordão Lino Dias, Camilla Akemi Felizardo Yamada, Carmen Lucia Penteado Lancellotti, Lázaro Luíz Faria do Amaral. Double calcification in PLNTY: an unusual presentation of a rare tumor in young patients. Arq Neuropsiquiatr 2025; 83: s00451809933.
DOI: 10.1055/s-0045-1809933
 

  • References

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