Fact-sheet: Ganglioglioma of brain
Updated on 08/15/2023 at 5:16 PM
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Definition
Well-differentiated, slow-growing neuroepithelial tumor.
Epidemiology:
- Children or young adults (80% of patients are under 30 years old)
- Slight male predominance
- Most common tumoral cause of temporal lobe epilepsy
Clinical features
Epilepsy
CT
Lesion of variable density:
- hypodense (40%)
- heterogeneous: hypodense cyst and isodense tissue nodule (30%)
- isodense or hyperdense (15%)
Calcifications common (35-50%)
Possible overlying bone remodeling
MRI
Cortical, well-defined lesion, predominantly temporal location ++
The typical appearance combines a cystic component with a mural nodule showing variable enhancement (generally moderate and heterogeneous enhancement).
Some gangliogliomas do not enhance.
T2* may suggest the presence of hypointense calcifications.
Spectroscopy: an increase in choline has been described
Management
Complete resection is generally curative
Classification
Grade I (80%)
Grade II
Grade III: anaplastic ganglioglioma
Grade IV: malignant glioblastoma-like form
Differential diagnosis
- Pleomorphic xanthoastrocytoma: dural tail ++
- DNET: intense T2 hyperintensity, rare enhancement
- Grade II astrocytoma: supratentorial locations other than the hypothalamus and optic chiasm are rare. Consistent, typical homogeneous enhancement.
- Oligodendroglioma: more extensive tumoral infiltration
- Neurocysticercosis: multiple lesions