A case of Lhermitte-Duclos disease: the classical “tiger stripes” in magnetic resonance imaging
DOI:
https://doi.org/10.13181/mji.cr.258118Keywords:
cerebellar neoplasms, Lhermitte-Duclos disease, magnetic resonance imagingAbstract
Dysplastic gangliocytoma or Lhermitte-Duclos disease (LDD), is a rare benign cerebellar tumor often presenting with nonspecific symptoms such as intracranial hypertension, cerebellar dysfunction, or cranial nerve deficits, and associated with phacomatosis. The characteristic “tiger stripe” sign on magnetic resonance imaging (MRI) is highly suggestive of LDD, though nodular medulloblastoma remains an important differential diagnosis. We report a 51-year-old woman with arm and leg phacomatosis who presented with a right cerebellar hypodense lesion on computed tomography extending frontally. MRI demonstrated the hallmark “tiger stripe” appearance, and histopathology following surgery confirmed LDD. On follow-up, despite evidence of a recurrent mass on MRI, her cranial nerve paresis improved postoperatively. Imaging revealed hypointense striations on T1 and alternating linear hyperintensities on T2 sequences, obscuring the cerebellar folia, features that distinguish LDD from other cerebellar tumors. This case underscores the diagnostic value of MRI, emphasizing early recognition to prevent misdiagnosis and guide surgical planning.
Downloads
References
Rissardo JP, Caprara AL. Lhermitte-Duclos disease (dysplastic cerebellar gangliocytoma): an overview. Formos J Surg. 2020;53(2):79-80. https://doi.org/10.4103/fjs.fjs_96_19
Borni M, Kammoun B, Kolsi F, Abdelmouleh S, Boudawara MZ. The Lhermitte-Duclos disease: a rare bilateral cerebellar location of a rare pathology. Pan Afr Med J. 2019;33:118. https://doi.org/10.11604/pamj.2019.33.118.16809
Assarzadegan F, Gharib A, Behbahani S, Ebrahimi-Abyaneh M. Intracranial hypertension and cerebellar symptoms due to Lhermitte-Duclos disease. Iran J Neurol. 2015;14(2):113-5.
Melinte DO, Vladareanu L. Facial expressions recognition for human-robot interaction using deep convolutional neural networks with rectified Adam optimizer. Sensors (Basel). 2020;20(8):2393. https://doi.org/10.3390/s20082393
Otheman Y, Aalouane R, Aarab C, Rammouz I. A case report of Lhermitte-Duclos disease revealed by psychiatric disturbances. Ann Gen Psychiatry. 2017;16:24. https://doi.org/10.1186/s12991-017-0147-1
Joo G, Doumanian J. Radiographic findings of dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease) in a woman with Cowden syndrome: a case study and literature review. J Radiol Case Rep. 2020;14(3):1-6. https://doi.org/10.3941/jrcr.v14i3.3814
Walke V, Bijwe S, D'Costa G, Jawarkar A. Lhermitte-Duclos disease in a young adult: rare entity. Iran J Pathol. 2013;8(3):194-8.
Bizimana W, Koudouhonon RO, Igombe SR, Amarkak WA, Benelhosni K, Nassar I, et al. A radiological curiosity of a rare diagnosis: Lhermitte-Duclos disease. Asian J Oncol. 2022;08(03):136-9. https://doi.org/10.1055/s-0042-1748638
Han C, Zhang Y, Ran C, Luo Y, Li W. Diverse imaging findings of Lhermitte-Duclos disease. Clin Radiol. 2023;78(1):33-9. https://doi.org/10.1016/j.crad.2022.08.134
Zhang HW, Zhang YQ, Liu XL, Mo YQ, Lei Y, Lin F, et al. MR imaging features of Lhermitte-Duclos disease: case reports and literature review. Medicine (Baltimore). 2022;101(4):e28667. https://doi.org/10.1097/MD.0000000000028667
McMahon ME, Murray D, MacNally S, O'Brien DF. Lhermitte-Duclos disease (dysplastic cerebellar gangliocytoma) in the setting of cowden syndrome: a case report and literature review on COLD syndrome. Br J Neurosurg. 2024;38(5):1170-3. https://doi.org/10.1080/02688697.2022.2106354
Pandey S, Sarma N. Lhermitte-Duclos disease: a rare cause of cerebellar ataxia. Asian J Neurosurg. 2017;12(4):705-6. https://doi.org/10.4103/ajns.AJNS_190_14
Beniwal HK, Satish T, Rao GP, Reddy MS, Manne S. Lhermitte-Duclos disease: incidental finding in traumatic cerebral hemorrhage. Indian J Neurotrauma. 2022;19(02):1-3. https://doi.org/10.1055/s-0041-1729136
Morisaki T, Kashiwagi S, Kouhashi R, Yabumoto A, Asano Y, Takashima T, et al. Cowden syndrome diagnosed by bilateral breast cancer with Lhermitte-Duclos disease: a case report. Case Rep Oncol. 2020;13(1):419-23. https://doi.org/10.1159/000506979
Kimura F, Ueda A, Sato E, Akimoto J, Kaise H, Yamada K, et al. Hereditary breast cancer associated with Cowden syndrome-related PTEN mutation with Lhermitte-Duclos disease. Surg Case Rep. 2017;3(1):83. https://doi.org/10.1186/s40792-017-0355-6
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131(6):803-20. https://doi.org/10.1007/s00401-016-1545-1
Alanazi AI, Alanezi T, Aljofan ZF, Alarabi A, Elwatidy S. Lhermitte-Duclos disease: a systematic review. Surg Neurol Int. 2023;14:351. https://doi.org/10.25259/SNI_555_2023
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Anggraini Dwi Sensusiati, Tedy Apriawan, Dyah Fauziah

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.



