Anaplastic ganglioglioma

Discussion:

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 a pediatric population, the incidence in young adults is higher than that of ganglioneuroma
  • Pilocytic astrocytoma: occurring 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 occurring in temporal lobes of young people, this is a relevant consideration in this case
  • cystic metastasis: cystic metastasis with a mural nodule is the last but not least differential for this lesion

The patient went on to have surgery. 

Histology

Final diagnosis: Anaplastic ganglioglioma (WHO grade III) with high-grade glial component resembling glioblastoma. 

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