Ganglioglioma: Single-institutional experience of 24 cases with review of literature

Abstract

Background:Ganglioglioma is a common seizure associated tumor. The goal of this study was to observe the postoperative outcome in patients with gangliogliomas.Material and Methods:A total 24 patients with gangliogliomas who underwent surgery at our institute from 2008 to 2011 were included. There were 13 males (54%) in our study. A retrospective analysis for the demographic profile, surgery and outcome was performed using STATA software. Literature on this subject was also reviewed, MEDLINE and PUBMED databases were searched.Observations:Sixteen patients presented with signs and symptoms of raised intracranial pressure and 12 patients had seizure disorder. Average age at surgery was 20 years (range 7-50 years). Twelve each were located in the temporal lobe and extra-temporal location. Intra-operative electrocorticography (ECoG) alone in three and image guidance alone were used in two patients, respectively. Both ECoG and image guidance were used in one patient and none of them was used in 18 patients. Gross total resection was achieved in 17 patients. After a mean follow-up of 1.6 years (range 3 months to 2.5 years), out of 12 patients with preoperative seizures, 10 (83.3%) were seizure free (Engel class-I) and 2 (16.6%) belonged to Engel class-II. None of the factors, including age at surgery, seizure duration prior to surgery, type of seizures, use of intra-operative ECoG and image guidance, extent of tumor resection, and surgical strategy proved to have significant correlation with postoperative seizure outcome.Conclusions:Surgical treatment is effective and safe for patients with gangliogliomas. Neither intra-operative ECoG nor image guidance necessarily leads to better seizure control, although they are useful adjunct for achieving safe and complete tumor resection.

Ganglioglioma Arising from the Septum Pellucidum

“… 9 The usual mode of presentation is due to signs and symptoms of raised intracranial pressure, focal neurological deficit, or seizure. 4 Contrary to the usual clinical scenario of seizure, our patient had no such manifestation. The duration of symptoms was found to range from 3 months to 45 years of age (mean age: 11 years) by the time the patient presented for surgical intervention.…”

“…Gangliogliomas are found often in males with an average age at presentation to be ranging in between 16 and 29 years. 4 However, some variants of ganglioglioma are more frequent in male, 12 while some have and equal sex distribution. 9 The usual mode of presentation is due to signs and symptoms of raised intracranial pressure, focal neurological deficit, or seizure.…”

“… 3 Despite being an omnipresent entity, most of these lesions are supratentorial, affecting the temporal lobes (>70%), in the basal diencephalon; the hypothalamus and within the vicinity of its slit-like cerebrospinal fluid cavity; and the third ventricle or the frontal lobes. 1 4 However, they are found to rarely involve the brainstem. The most common mode of presentation is seizure or change in the pattern of preexisting seizure activity which are usually refractory to pharmacotherapy.…”

Ganglioglioma Arising from the Septum Pellucidum: Case Report and Review of the Literature

“…The average age at clinical presentation of gangliogliomas in general has been reported to be between 16 and 29 years old [7]. Similarly, the average age at diagnosis of intraventricular gangliogliomas is 28 years old.…”

“…The median age at diagnosis ranges from 8.5 to 25 years with a male to female ratio of 1.1– 1.9: 1 [3-5]. These tumors can be found anywhere within the central nervous system, with the temporal lobe being most commonly affected (> 70%) [1, 4, 6, 7]. Patients most commonly present with focal motor seizures.…”