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