Ganglioglioma with anaplastic recurrence of the neuronal element following radiotherapy

Tarnaris, Andrew; O'Brien, C J; Redfern, Robert M.

doi:10.1016/j.clineuro.2005.09.005

Cited by 29 publications

(30 citation statements)

References 25 publications

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“…According to Rades et al [8], the criteria for high-grade tumors are the presence of anaplastic histologic features or the presence of an MIB-1 labeling index >10%. More frequently, the malignant characteristics are featured by the glial component, but cases where both the astrocytic and ganglionic populations are malignant, as in the case described here, have previously been reported[9,10,11,12,13,14]. …”

Section: Discussionmentioning

confidence: 82%

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Pediatric Primary Anaplastic Ganglioglioma: A Case Report and Review of the Literature

et al. 2012

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Gangliogliomas with anaplastic features are classified as grade III tumors by the World Health Organization. The clinical course and optimal treatment of anaplastic gangliogliomas have not been well understood to date. We report a case of a primary pure anaplastic ganglioglioma in a 14-year-old male treated with surgery and radiotherapy, who is disease-free 6 years after the diagnosis. A review of primary pure anaplastic gangliogliomas in children (between 3 and 21 years of age) is presented. Gross total removal and focal radiotherapy with a total dose of 54 Gy are recommended. The addition of chemotherapy should be evaluated. Prospective studies are needed to identify an appropriate chemotherapy schedule and to define biological factors in order to select those patients with a poor prognosis, who are to be treated with a more aggressive therapy.

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Section: Discussionmentioning

confidence: 82%

“…Since the malignant degeneration has been described both in previously irradiated [14,17] and nonirradiated patients [11,18,19,20], the evidence for a relationship between RT and anaplastic transformation seems to be weak [21]. …”

Section: Discussionmentioning

confidence: 99%

Pediatric Primary Anaplastic Ganglioglioma: A Case Report and Review of the Literature

et al. 2012

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“…To date, only four cases have been described as anaplastic ganglioglioma with malignant neuronal components: a spinal cord ganglioglioma with``very few mitoses'' in both components 2) ; an initially benign ganglioglioma with anaplastic changes in both neuronal and astrocytic cells after radiotherapy 13) ; and a benign ganglioglioma with anaplastic recurrence of neuronal elements 3 years after radiotherapy. 15) Only one case was reported as cerebral ganglioglioma with malignant transformation in both astroglial and neuronal cell components and was not associated with radiotherapy. 12) Malignant transformation is thought to be associated with radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…9) To date, only four cases of ganglioglioma have been reported with anaplastic recurrence in the neuronal element, and two cases involved malignant transformation following radiation therapy. 2,12,13,15) Here, we present a case of anaplastic ganglioglioma with rapidly progressive malignant features in both morphological neuronal and glial components with expression of the neural stem cell marker nestin.…”

Section: Introductionmentioning

confidence: 99%

Anaplastic Ganglioglioma With Malignant Features in Both Neuronal and Glial Components -Case Report-

Kawataki

Sato

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 34-year-old man presented with a case of anaplastic ganglioglioma with malignant features in both neuronal and glial components manifesting as seizure episodes over 11 months. The tumor was subtotally removed, followed by irradiation and chemotherapy. The histological diagnosis was anaplastic ganglioglioma. Atypical cells were morphologically estimated as glial and neuronal cells. Though these cells were weakly positive for synaptophysin and glial fibrillary acidic protein, the neural stem cell marker nestin was extremely expressed in both these cells. The MIB-1 index was 15%. Two months later, the tumor recurred with more pleomorphic appearance and higher cellularity with increased nestin expression level. Mitotic cells and multinucleated cells were found in the neuronal components. Cytological examination found dissemination to the leptomeningeal space. The patient died 6 months after the first surgery. This rare case of anaplastic ganglioglioma with both neuronal and glial components, which were extremely positive for nestin, showed progressive worsening of the clinical course. The expression of nestin may suggest that the origin or malignant transformation in anaplastic gangliogliomas is related to the undifferentiated neural stem cells.

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“…22 As such, adjuvant treatment following subtotal resection is often recommended and may include radiation 1,22,24,26 and/ or chemotherapy. 25 We observed that a substantial portion of our patients with GG presented with atypical clinical and imaging features.…”

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confidence: 99%

Atypical pediatric ganglioglioma is common and associated with a less favorable clinical course

Patibandla¹,

Ridder²,

Dorris³

et al. 2016

Journal of Neurosurgery: Pediatrics

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OBJECT Ganglioglioma (GG) is commonly recognized as a low-grade tumor located in the temporal lobe, often presenting with seizures. Most are amenable to complete resection and are associated with excellent oncological outcome. The authors encountered several GGs in various locations, which seem to have a less favorable clinical course than GGs in the temporal lobe. METHODS The authors performed a single-center retrospective review of all children with a histological diagnosis of GG who were treated at Children’s Hospital Colorado between 1997 and 2013. Each tumor was categorized by 2 pediatric neuroradiologists as typical or atypical based on preoperative MRI appearance. Typical lesions were cortically based, within a single cerebral lobe, well-circumscribed, and solid or mixed solid/cystic. The treatment and clinical course of each patient was analyzed. RESULTS Thirty-seven children were identified, with a median age at presentation of 8.2 years and median follow-up of 38.0 months. Eighteen tumors (48.6%) were typical and 19 (51.4%) were atypical. All typical lesions presented with seizures, whereas no atypical lesions did so. Sixteen (88.9%) typical lesions were located in the temporal lobe. In the atypical group, tumor location was variable, including 11 (57.9%) in the brainstem. Death during follow-up was statistically more common in the atypical group (31.6% vs 0%, p = 0.02). Gross-total resection (GTR) was achieved for 15 of 16 typical tumors (93.8%), compared with 3 atypical tumors (15.8%, p < 0.0001). Presentation with seizure or non-brainstem location were each associated with survival (p = 0.02 and 0.004, respectively). The presence of mutation in BRAF exon 15 did not differ between the 2 groups. CONCLUSIONS Pediatric GG with typical imaging features is associated with excellent rates of GTR and overall survival. Atypical GG is commonly encountered, less amenable to GTR, and associated with a worse outcome. This may relate to anatomical or biological characteristics and merits further investigation.

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Ganglioglioma with anaplastic recurrence of the neuronal element following radiotherapy

Cited by 29 publications

References 25 publications

Pediatric Primary Anaplastic Ganglioglioma: A Case Report and Review of the Literature

Pediatric Primary Anaplastic Ganglioglioma: A Case Report and Review of the Literature

Anaplastic Ganglioglioma With Malignant Features in Both Neuronal and Glial Components -Case Report-

Atypical pediatric ganglioglioma is common and associated with a less favorable clinical course

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