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Ganglioglioma

Archie R McGowan, MD
Liangge Hsu, MD

Presentation

A 34-year-old man presented with seizures after experiencing mild head trauma during a motor vehicle accident. He had an eight-year history of partialized and generalized seizures localized to the left temporal lobe.

Imaging Findings

T2-weighted axial MRI
T2-weighted coronal fast spin echo
T1-weighted gadolinium-enhanced coronal MRI

T2-weighted axial magnetic resonance imaging (MRI) reveals an area of moderately increased abnormal signal intensity in the left temporal lobe (arrow) and mild mass effect without significant associated edema.

A T2-weighted fast spin echo coronal image also indicates an area of moderately increased abnormal signal intensity in the left temporal lobe (arrow).

A T1-weighted gadolinium-enhanced coronal image reveals the previously identified abnormality in the left temporal lobe to be exerting very mild mass effect in the area of the left lateral ventricle and atrium. The lack of contrast enhancement (arrow) on this image is particularly notable.

Differential Diagnosis

The differential diagnosis includes gliosis, low grade astrocytoma, ganglioglioma, and hamartoma.

Diagnosis

Ganglioglioma

Discussion

Gangliogliomas are mixed cell tumors containing both neural ganglionic cells and neural glial cell components. The characteristic imaging findings include increased signal intensity on T2-weighted images with or without calcifications. These tumors often do not enhance brightly and may contain a cystic component. Hemorrhage is rarely associated with gangliogliomas.

In adults, 70% of gangliogliomas are supratentorial with a predilection for the temporal lobes.

The most common age for presentation is in adolescence and young adulthood. If these tumors are fully resected, patients have an excellent prognosis.

References

1. Atlas SW. Magnetic resonance imaging of the brain and spine. New York: Raven, 1991: 260-272.

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