Source: Dr. Frank Gaillard
Radiopaedia.org
Date: Monday, August 18, 2008
Images
Fig.1: T2 FSE.
Fig.2: Coronal T1 (non contrast).
Fig.3: T1 post contrast.
Patient Hx
Patient presents with gradual decrease in vision.
Differential Diagnosis
- A. Craniopharyngioma
- B. Pituitary macroadenoma
- C. Ganglioglioma of the optic nerve
- D. Exophytic hypothalamic astrocytoma
- E. Suprasellar meningioma
Final Review - Click here -->
Final Diagnosis
Ganglioglioma of the optic nerve.
Discussion
This patient presented with gradual decrease in vision, and partial excision confirmed a ganglioglioma of the optic nerve.
Gangliogliomas are a low grade tumor (WHO Grade I or II) which typically occur in the temporal lobes of young patients and present with temporal lobe epilepsy. 80% of cases are found in <30 year of age, however they have been reported at all ages. Following complete resection, prognosis is excellent and 80% are seizure free.
They demonstrate 3 types of growth pattern:
- Circumscribed cyst with enhancing mural nodule (most common)
- Solid mass with expands gyrus
- Diffuse infiltrating mass (uncommon)
Calcification is common (35-50%), and enhancement is variable, sometimes extending beyond the nodule into the wall of cyst.
They are often associated with cortical dysplasia, and have been reported in association with DNETs, oligodendrogliomas and even tanycytic ependymomas. Anaplastic variants (WHO Grade III) and malignant degeneration into GBM-like tumors (WHO Grade IV) is rare.
References
- Diagnostic Imaging: BRAIN by Osborn.
Notes
Images are licensed under Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported.
