Ganglioglioma
The Common Vein Copyright 2010
Definition
A ganglioglioma is the most common brain tumor seen in the setting of chronic temporal lobe epilepsy, most often presenting in children and young adults. Although rare, it is also the most common neuronal-glial tumor in the CNS.
Pathologically it is characterized by the presence of both neoplastic ganglion cells and neural cells as suggested by its name. This tumor is well differentiated and grows slowly. Only rarely do these tumors demonstrate malignant degeneration.
As mentioned above, patients with this tumor present with chronic temporal lobe epilepsy.
Diagnosis can be suspected based on combination of history and findings however the imaging findings detailed below can be seen in other entities as well.
On imaging, gangliogliomas are typically peripheral masses. They may be solid, cystic, or a combination of both. On CT, approximately 30 % demonstrate calcification. They are generally T2 hyperintense, T1 isointense to hypointense although intralesional calcification which is common can cause increased T1 signal. The enhancement characteristics of these lesions are variable. This slow growing tumor may remodel and thin the overlying skull.
Preferred treatment of these low grade tumors is surgical resection. If completely resected, the prognosis is excellent. Postoperative radiation with possible chemotherapy is used for incomplete resection.