A mass with heterogeneous calcification is present in the right frontal lobe, superior frontal gyrus with surrounding edema. A component of the mass demonstrates contrast enhancement.
MRI confirms the CT findings and shows the mass to be heterogeneous with cystic components, enhancing components with dependent blood products within the most anterior cystic component.
Case Discussion
The patient went on to have a resection.
Histology:
Sections show multiple small fragments of neuropil containing focal collections of atypical ganglion cell neurons. These cells have large round nuclei with prominent nucleoli, abundant cytoplasm and peripheral Nissl substance. The cells are atypical in their morphology, orientation and spacial arrangement. Many blood vessels are surrounded by small cuffs of reactive lymphocytes. The intervening neuropil shows a mild degree of reactive gliosis, occasional axonal steroids and multiple small calcified deposits, resembling psammoma bodies. There does not appear to be any neoplastic glial component to this lesion.
Final Diagnosis: gangliocytoma.