Bilateral thalamic anaplastic ganglioglioma

Case contributed by Dr Dalia Ibrahim

Presentation

Headache and bilateral upper limb numbness.

Patient Data

Age: 15 years
Gender: Male

Bilateral thalamic space-occupying lesions, larger on the right side showing aggressive features. Both lesions elicit high signal on T2 and FLAIR WI, however, on the right side, it shows areas of diffusion restriction,  heterogenous post-contrast enhancement, and internal hemorrhage and cystic necrosis. Lesions exert mass effect in the form of compression of the third ventricle and Sylvian aqueduct, with subsequent supartentorial moderate hydrocephalus and CSF permeation.

Features were suggestive of bilateral thalamic gliomas, of a higher grade on the right side.

Stereotactic biopsy

Photo

Stereotactic biopsy of the right thalamic lesion showed grade III anaplastic ganglioglioma.

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