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Case 3Young adult with HA and seizures.

Ganglioglioma

Rare: approximately 1-3% of brain tumors.

Most common children and young adults <30 yo.

Contain both glial elements and differentiated nerve cells.

Low grade neoplasm WHO I - II.

Slow growing.

Ganglioglioma

Clinical presentation depends on location of the neoplasm.

Most common location: Temporal lobe> parietal and frontal lobes.

Can occur anywhere.

Most common presentation: Seizures > HA.

Ganglioglioma

Imaging morphology:

Three patterns:

Most common: Circumscribed cyst with mural nodule.

Solid Tumor.

Uncommon: Infiltrating, poorly-delineated mass.

Ganglioglioma

CT findings:

Hypodense.

Mixed: hypodense/cyst-hyperdense/nodule.

Calcification common.

Enhancement: variable - solid, rim, or nodular.

Ganglioglioma

MR findings:

Hypointense on T1.

Hyperintense on T2.

GRE: hypointense calcification.

Enhancement: variable - can be minimal, homogeneous, ring-like, or nodular.

Ganglioglioma

Ddx:

Pleomorphic xanthoastrocytoma.

Rare: cystic with mural nodule

Temporal lobe most common.

Pilocytic astrocytoma.

Cyst with mural nodule.

Supratentorial location rare.

Low grade astrocytoma.

Mass with no enhancement.

Oligodendroglioma.

Calcified heterogeneous mass.

Dysembryoplastic neuroepithelial tumor (DNET).

Cystic neoplasm “bubbly” appearance.

Children &young adults.