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==Pathophysiology==
==Pathophysiology==
Ganglioglioma arises from neuronal glial cells, which are cells of the [[central nervous system]]. It is a rare disease that tends to affect children, adolescents, and young adults. Ganglioglioma affects male and female equally. On gross pathology, ganglioglioma varies from partially cystic mass with a mural nodule to a solid mass expanding the overlying [[gyrus]]. On microscopic pathology, ganglioglioma is composed of [[ganglion cells]] and neoplastic glial cells with positive staining for [[synaptophysin]], neuronal specific enolase, and [[GFAP]].
 
==Causes==
==Causes==
There are no established causes for ganglioglioma.
 


==Differentiating brain tumors from other diseases==
==Differentiating brain tumors from other diseases==
Ganglioglioma must be differentiated from dysembryoplastic neuroepithelial tumors, pleomorphic xanthoastrocytoma, [[oligodendroglioma]], desmoplastic infantile ganglioglioma, [[astrocytoma]], [[ependymoma]], and [[transverse myelitis]].


==Epidemiology and Demographics==
==Epidemiology and Demographics==
Ganglioglioma is the most frequent neuronal-glial [[CNS]] neoplasm. It is a rare disease that tends to affect children, adolescents, and young adults. Ganglioglioma affects male and female equally.


==Risk factors==
==Risk factors==
There are no established risk factors for ganglioglioma.


==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==
If left untreated, patients with ganglioglioma may progress to develop local recurrence. Complications that can develop as a result of ganglioglioma are [[metastasis]] and local recurrence. Prognosis is generally good with treatment.<ref name=dd>Features of ganglioglioma. Dr Henry Knipe and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/ganglioglioma</ref>


==Diagnosis==
==Diagnosis==

Revision as of 13:55, 11 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

Pathophysiology

Causes

Differentiating brain tumors from other diseases

Epidemiology and Demographics

Risk factors

Natural History, Complications and Prognosis

Diagnosis

Staging

There is no established system for the staging of ganglioglioma.

History and Symptoms

The hallmark of cerebral ganglioglioma is temporal lobe epilepsy.[1] Most common symptoms of spinal cord ganglioglioma include back pain, neck pain, radicular pain, weakness, paresthesia, gait disturbance, and bowel and bladder dysfunction. Less common symptoms of spinal cord ganglioglioma include Brown-Sequard syndrome, acute headache due to subarachnoid hemmorhage, progressive scoliosis, loss of motor function, and frequent falls.[2]

Physical examination

Common physical examination findings of ganglioglioma include weak irregular pulse, hypertension, wide pulse pressure, unilateral pupillary dilatation, abnormal ophthalmic examination, and focal neurological deficits.[3]

Laboratory Findings

There are no diagnostic lab findings associated with ganglioglioma.

X Ray

There are no x-ray findings associated with cerebral ganglioglioma. On x-ray, spinal cord ganglioglioma is characterized by scoliosis, bony remodelling, posterior vertebral body scalloping, and remodelling of the pedicle or posterior arch.[2]

CT

On head CT scan, ganglioglioma is characterized by iso- or hypodense, calcification, bone remodelling, and enhancement of solid non-calcified component.

MRI

On MRI brain, ganglioglioma is characterized by iso- to hypointense solid component on T1, variable contrast enhancement of solid component on T1 C+ (Gd), hyperintense solid component and variable signal in cystic component on T2, and calcification on T2 (GE/SWI).[1] On MRI scan of spinal cord, ganglioglioma is characterized by mixed signal intensity on T1-weighted images, high intensity on T2, patchy enhancement on T1 C+ (Gd), and calcification with low signal blooming on gradient echo.[2]

Ultrasound

There are no ultrasound findings associated with ganglioglioma.

Other imaging findings

There are no other imaging findings associated with ganglioglioma.

Other Diagnostic Studies

There are no other diagnostic studies associated with ganglioglioma.

Treatment

Medical Therapy

Radiotherapy or chemotherapy is not the first-line treatment option for patients with gangliogliomas. Radiation therapy is usually reserved for patients when either incomplete resection is achievable or tumor recurrence occurs.[1]

Surgery

The mainstay of therapy for ganglioglioma is surgery. In the brain, a reasonable resection margin can be achieved with surgery.[1]



References

  1. 1.0 1.1 1.2 1.3 Symptoms of ganglioglioma. Dr Henry Knipe and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/ganglioglioma
  2. 2.0 2.1 2.2 Presentation of spinal cord ganglioglioma. Dr Ayush Goel and Dr Sara Wein et al. Radiopaedia 2015. http://radiopaedia.org/articles/spinal-ganglioglioma
  3. Presentation of increased ICP. Patient.info. http://patient.info/doctor/raised-intracranial-pressure


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