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. 2025 Oct 30;176(1):57.
doi: 10.1007/s11060-025-05289-2.

Radiologic characterization and clinical management of multinodular and vacuolating neuronal tumor (MVNT): a retrospective institutional cohort study

Austin Carmichael  1 , Umar Arshad  1 , Daniel Martinez Heinemann  1 , Sai Chandan Reddy  1 , Anita Kalluri  1 , Antolin Serrano-Farias  1 , Praneethkumar Madhu  1 , Dhairya A Lakhani  2 , Haris Sair  1   2 , Karisa C Schreck  3   4 , Calixto-Hope Lucas  5 , Ignacio Gonzalez-Gomez  6 , George I Jallo  1   7 , Chetan Bettegowda  1 , Jordina Rincon-Torroella  8
Affiliations

Radiologic characterization and clinical management of multinodular and vacuolating neuronal tumor (MVNT): a retrospective institutional cohort study

Austin Carmichael et al. J Neurooncol. .

Abstract

Purpose: Multinodular and vacuolating neuronal tumor (MVNT) is a rare, benign entity first recognized by the World Health Organization in 2016. Given that patients with MVNT often present incidentally or with nonspecific symptoms, understanding imaging characteristics and treatment strategies is critical to effective management. This study describes the radiologic characteristics and clinical outcomes of individuals with MVNT through a large retrospective cohort.

Methods: A tertiary academic center's radiology database was queried for individuals with "Multinodular and Vacuolating Neuronal Tumors," "MVNT," or "T2-hyperintense nodules." Of 190 patients, 27 were identified with radiologically determined MVNT by two expert neuroradiologists. Clinical, imaging, and management data were collected through retrospective chart review.

Results: The median age at radiologic discovery of MVNT was 43 years (6-81 years). The most common symptoms at presentation included headaches (11/26, 42.3%) and seizures (7/26, 26.9%). On MRI, MVNTs were often subcortical, nodular lesions that appeared hypointense on T1-weighted imaging (25/27, 92.6%), hyperintense on T2-weighted imaging (27/27, 100%), fluid-attenuated inversion recovery hyperintense (27/27, 100%), and non-contrast enhancing (23/27, 85.2%). Most individuals pursued conservative management with imaging (23/26, 88.5%), though three patients underwent surgery (3/26, 11.5%). Presenting symptoms improved in most conservatively managed (16/23, 69.6%) and both surgical (2/2, 100%) cases by the last follow-up. Neither progression nor recurrence was observed in any case.

Conclusions: This study highlights the nonspecific presentation and characteristic MRI features of MVNT. Our findings support conservative imaging follow-up for most patients with MVNT, though surgery may benefit select patients with severe symptoms, including drug-resistant epilepsy.

Keywords: Incidental finding; Multinodular and vacuolating neuronal tumor; Neuroradiology; Seizures.

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Conflict of interest statement

Declarations. Ethical approval: The Johns Hopkins University School of Medicine Institutional Review Board provided approval prior to the initiation of this study. Competing interests: Chetan Bettegowda is a consultant for Haystack Oncology, Privo Technologies and Bionaut Labs. Chetan Bettegowda is a co-founder of OrisDx and Belay Diagnostics.

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