This is a differential diagnosis case of a temporal lobe cystic lesion in a young adult. There are a few relevant entities one must consider when encountering a lesion of this appearance in this age group:
- ganglioneuroma: Fully differentiated neural tumors, 60% occurring below the age of 20 years1, can demonstrate solid and cystic components as well as fine, speckled calcification.
- ganglioglioma: Although primarily occurs in pediatric population, the incidence in young adults is higher than that of ganglioneuroma
- Pilocytic astrocytoma: Occuring mostly in pediatric age group, 60% are found in cerebellum with optic nerve, hypothalamus and brain stem consisting most of the other 40%. The location of the lesion in this case is somewhat unusual for a pilocytic astrocytoma
- DNET: Mostly occuring in temporal lobes of young people, this is a relevant consideration in this case
- cystic metastasis: Cystic metastasis with mural nodule is the last but not least differential for this lesion.
Histopathology result: Anaplastic ganglioglioma with high-grade glial component resembling glioblastoma (WHO grade 3).