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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1994 Jun;57(6):699–704. doi: 10.1136/jnnp.57.6.699

Association of Lhermitte-Duclos and Cowden disease: report of a new case and review of the literature.

M Vinchon 1, S Blond 1, J P Lejeune 1, I Krivosik 1, P Fossati 1, R Assaker 1, J L Christiaens 1
PMCID: PMC1072973  PMID: 8006650

Abstract

Lhermitte-Duclos disease is a rare entity, and its pathological features are unique. Pathological findings are characteristic of the disease, with global hypertrophy of the cerebellum, coarse gyri, and the typical "inverted cortex" pattern. Several associated lesions were noted in many patients with Lhermitte-Duclos disease. It is only recently that an association between Lhermitte-Duclos disease and Cowden disease was reported. Cowden disease, or multiple hamartomas syndrome, is a familial disease associating breast cancer, cutaneomucous tricholemmomas, and various other tumoural and dysplasic conditions. A new case of Lhermitte-Duclos disease associated with Cowden disease is reported. A review of the literature found 72 cases of Lhermitte-Duclos disease; 26 had conditions suggesting Cowden disease and seven were definite cases of Cowden disease. The association of Lhermitte-Duclos disease and Cowden disease is probably underestimated. Cowden disease represents a new form of phakomatosis; Lhermitte-Duclos disease may occur as a sporadic disease, or as part of familial Cowden disease. The possibility of preneoplastic states in Cowden syndrome stresses the importance of a thorough screening when Lhermitte-Duclos disease is diagnosed.

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Selected References

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  1. Ambler M., Pogacar S., Sidman R. Lhermitte-Duclos disease (granule cell hypertrophy of the cerebellum) pathological analysis of the first familial cases. J Neuropathol Exp Neurol. 1969 Oct;28(4):622–647. doi: 10.1097/00005072-196910000-00005. [DOI] [PubMed] [Google Scholar]
  2. Ashley D. G., Zee C. S., Chandrasoma P. T., Segall H. D. Lhermitte-Duclos disease: CT and MR findings. J Comput Assist Tomogr. 1990 Nov-Dec;14(6):984–987. doi: 10.1097/00004728-199011000-00022. [DOI] [PubMed] [Google Scholar]
  3. Beuche W., Wickboldt J., Friede R. L. Lhermitte-Duclos disease--its minimal lesions in electron microscope data and CT findings. Clin Neuropathol. 1983;2(4):163–170. [PubMed] [Google Scholar]
  4. Brown W. R., Angelo J. N., Kelly D. L., Jr Lhermitte-Duclos disease: case report with computerized tomographic scan. Neurosurgery. 1980 Feb;6(2):189–191. doi: 10.1227/00006123-198002000-00013. [DOI] [PubMed] [Google Scholar]
  5. CARBONE F., BRIHAYE J., DROCHMANS P. Spongioblastome pariéto-occipital et gangliocytome dysplasique du cervelet chez le même malade. Acta Neurol Psychiatr Belg. 1955 Jul;55(7):568–580. [PubMed] [Google Scholar]
  6. Carter J. E., Merren M. D., Swann K. W. Preoperative diagnosis of Lhermitte-Duclos disease by magnetic resonance imaging. Case report. J Neurosurg. 1989 Jan;70(1):135–137. doi: 10.3171/jns.1989.70.1.0135. [DOI] [PubMed] [Google Scholar]
  7. Di Lorenzo N., Lunardi P., Fortuna A. Granulomolecular hypertrophy of the cerebellum (Lhermitte-Duclos disease). Case report. J Neurosurg. 1984 Mar;60(3):644–646. doi: 10.3171/jns.1984.60.3.0644. [DOI] [PubMed] [Google Scholar]
  8. FISCHER W., BUSCH K. T. GANGLIOZYTOME. KLINISCHE UND MORPHOLOGISCHE BETRACHTUNGEN. Zentralbl Neurochir. 1963;23:286–311. [PubMed] [Google Scholar]
  9. Faillot T., Sichez J. P., Brault J. L., Capelle L., Kujas M., Bordi L., Boukobza M. Lhermitte-Duclos disease (dysplastic gangliocytoma of the cerebellum). Report of a case and review of the literature. Acta Neurochir (Wien) 1990;105(1-2):44–49. doi: 10.1007/BF01664857. [DOI] [PubMed] [Google Scholar]
  10. Ferrer I., Isamat F., Acebes J. A Golgi and electron microscopic study of a dysplastic gangliocytoma of the cerebellum. Acta Neuropathol. 1979 Jul 13;47(2):163–165. doi: 10.1007/BF00717043. [DOI] [PubMed] [Google Scholar]
  11. Gessaga E. C. Lhermitte-Duclos disease (diffuse hypertrophy of the cerebellum). Report of two cases. Neurosurg Rev. 1980;3(2):151–158. doi: 10.1007/BF01644067. [DOI] [PubMed] [Google Scholar]
  12. HALLERVORDEN J. [On hamartoma (ganglioneuroma) of the cerebellum]. Dtsch Z Nervenheilkd. 1959;179:531–563. [PubMed] [Google Scholar]
  13. Hair L. S., Symmans F., Powers J. M., Carmel P. Immunohistochemistry and proliferative activity in Lhermitte-Duclos disease. Acta Neuropathol. 1992;84(5):570–573. doi: 10.1007/BF00304477. [DOI] [PubMed] [Google Scholar]
  14. Harff E. G., Vinken P. J. A case of diffuse cerebellar hypertrophy. Acta Neuropathol. 1966 Jan 14;6(1):106–111. doi: 10.1007/BF00691089. [DOI] [PubMed] [Google Scholar]
  15. King M. A., Coyne T. J., Spearritt D. J., Boyle R. S. Lhermitte-Duclos disease and Cowden disease: a third case. Ann Neurol. 1992 Jul;32(1):112–113. doi: 10.1002/ana.410320122. [DOI] [PubMed] [Google Scholar]
  16. LLOYD K. M., 2nd, DENNIS M. Cowden's disease. A possible new symptom complex with multiple system involvement. Ann Intern Med. 1963 Jan;58:136–142. doi: 10.7326/0003-4819-58-1-136. [DOI] [PubMed] [Google Scholar]
  17. Leech R. W., Christoferson L. A., Gilbertson R. L. Dysplastic gangliocytoma (Lhermitte-Duclos disease) of the cerebellum. Case report. J Neurosurg. 1977 Oct;47(4):609–612. doi: 10.3171/jns.1977.47.4.0609. [DOI] [PubMed] [Google Scholar]
  18. Lejeune J. P., Blond S., Dupard T., Combelles G., Delandsheer J. M., Christiaens J. L. Maladie de Lhermitte-Duclos. A propos d'une observation. Neurochirurgie. 1987;33(5):408–411. [PubMed] [Google Scholar]
  19. Marano S. R., Johnson P. C., Spetzler R. F. Recurrent Lhermitte-Duclos disease in a child. Case report. J Neurosurg. 1988 Oct;69(4):599–603. doi: 10.3171/jns.1988.69.4.0599. [DOI] [PubMed] [Google Scholar]
  20. McCombe P., Warren B. A. A case of Lhermitte-Duclos disease. Clin Exp Neurol. 1983;19:120–122. [PubMed] [Google Scholar]
  21. Milbouw G., Born J. D., Martin D., Collignon J., Hans P., Reznik M., Bonnal J. Clinical and radiological aspects of dysplastic gangliocytoma (Lhermitte-Duclos disease): a report of two cases with review of the literature. Neurosurgery. 1988 Jan;22(1 Pt 1):124–128. doi: 10.1227/00006123-198801010-00020. [DOI] [PubMed] [Google Scholar]
  22. Padberg G. W., Schot J. D., Vielvoye G. J., Bots G. T., de Beer F. C. Lhermitte-Duclos disease and Cowden disease: a single phakomatosis. Ann Neurol. 1991 May;29(5):517–523. doi: 10.1002/ana.410290511. [DOI] [PubMed] [Google Scholar]
  23. Pritchett P. S., King T. I. Dysplastic gangliocytoma of the cerebellum--an ultrastructural study. Acta Neuropathol. 1978 Apr 26;42(1):1–5. doi: 10.1007/BF01273258. [DOI] [PubMed] [Google Scholar]
  24. Reeder R. F., Saunders R. L., Roberts D. W., Fratkin J. D., Cromwell L. D. Magnetic resonance imaging in the diagnosis and treatment of Lhermitte-Duclos disease (dysplastic gangliocytoma of the cerebellum). Neurosurgery. 1988 Aug;23(2):240–245. doi: 10.1227/00006123-198808000-00022. [DOI] [PubMed] [Google Scholar]
  25. Reznik M., Schoenen J. Lhermitte-Duclos disease. Acta Neuropathol. 1983;59(2):88–94. doi: 10.1007/BF00691592. [DOI] [PubMed] [Google Scholar]
  26. Rilliet B., Mori Y. Gangliocytome dysplasique de cervelet. Schweiz Arch Neurol Neurochir Psychiatr. 1979;124(1):13–27. [PubMed] [Google Scholar]
  27. Roach E. S., Williams D. P., Laster D. W. Magnetic resonance imaging in tuberous sclerosis. Arch Neurol. 1987 Mar;44(3):301–303. doi: 10.1001/archneur.1987.00520150047020. [DOI] [PubMed] [Google Scholar]
  28. Roessmann U., Wongmongkolrit T. Dysplastic gangliocytoma of cerebellum in a newborn. Case report. J Neurosurg. 1984 Apr;60(4):845–847. doi: 10.3171/jns.1984.60.4.0845. [DOI] [PubMed] [Google Scholar]
  29. Rousseaux M., Combelles G., Krivosik Y., Christiaens J. L. Maladie de Lhermitte-Duclos. Hypertrophie granulo-moléculaire du cervelet. Neurochirurgie. 1987;33(3):232–235. [PubMed] [Google Scholar]
  30. Ruchoux M. M., Gray F., Gherardi R., Schaeffer A., Comoy J., Poirier J. Orthostatic hypotension from a cerebellar gangliocytoma (Lhermitte-Duclos disease). Case report. J Neurosurg. 1986 Aug;65(2):245–248. doi: 10.3171/jns.1986.65.2.0245. [DOI] [PubMed] [Google Scholar]
  31. Sabin H. I., Lidov H. G., Kendall B. E., Symon L. Lhermitte-Duclos disease (dysplastic gangliocytoma): a case report with CT and MRI. Acta Neurochir (Wien) 1988;93(3-4):149–153. doi: 10.1007/BF01402899. [DOI] [PubMed] [Google Scholar]
  32. Schafer J. A., Berg B. O., Norman D. Cerebellular calcification in tuberous sclerosis. Arch Neurol. 1975 Sep;32(9):642–643. doi: 10.1001/archneur.1975.00490510098012. [DOI] [PubMed] [Google Scholar]
  33. Shanley D. J., Vassallo C. J. Atypical presentation of Lhermitte-Duclos disease: preoperative diagnosis with MRI. Neuroradiology. 1992;34(2):103–104. doi: 10.1007/BF00588151. [DOI] [PubMed] [Google Scholar]
  34. Shiurba R. A., Gessaga E. C., Eng L. F., Sternberger L. A., Sternberger N. H., Urich H. Lhermitte-Duclos disease. An immunohistochemical study of the cerebellar cortex. Acta Neuropathol. 1988;75(5):474–480. doi: 10.1007/BF00687134. [DOI] [PubMed] [Google Scholar]
  35. Smith R. R., Grossman R. I., Goldberg H. I., Hackney D. B., Bilaniuk L. T., Zimmerman R. A. MR imaging of Lhermitte-Duclos disease: a case report. AJNR Am J Neuroradiol. 1989 Jan-Feb;10(1):187–189. [PMC free article] [PubMed] [Google Scholar]
  36. Sonier C. B., Feve J. R., De Kersaint-Gilly A., Ruchoux M. M., Rymer R., Auffray E. Lhermitte-duclos disease. A rare cause of intracranial hypertension in adults. J Neuroradiol. 1992;19(2):133–138. [PubMed] [Google Scholar]
  37. Stapleton S. R., Wilkins P. R., Bell B. A. Recurrent dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease) presenting with subarachnoid haemorrhage. Br J Neurosurg. 1992;6(2):153–156. doi: 10.3109/02688699209002919. [DOI] [PubMed] [Google Scholar]
  38. Starink T. M. Cowden's disease: analysis of fourteen new cases. J Am Acad Dermatol. 1984 Dec;11(6):1127–1141. doi: 10.1016/s0190-9622(84)70270-2. [DOI] [PubMed] [Google Scholar]
  39. Williams D. W., 3rd, Elster A. D., Ginsberg L. E., Stanton C. Recurrent Lhermitte-Duclos disease: report of two cases and association with Cowden's disease. AJNR Am J Neuroradiol. 1992 Jan-Feb;13(1):287–290. [PMC free article] [PubMed] [Google Scholar]
  40. Yachnis A. T., Trojanowski J. Q., Memmo M., Schlaepfer W. W. Expression of neurofilament proteins in the hypertrophic granule cells of Lhermitte-Duclos disease: an explanation for the mass effect and the myelination of parallel fibers in the disease state. J Neuropathol Exp Neurol. 1988 May;47(3):206–216. doi: 10.1097/00005072-198805000-00002. [DOI] [PubMed] [Google Scholar]

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