Gangliocytomas are rare benign (WHO grade I) CNS tumours which differ from gangliogliomas by the absence of neoplastic glial cells. Both tumours are defined by the presence of displaced ganglion cells (large mature neurons that show cytological or architectural abnormalities).
On imaging these tumours are usually characterised by cortical solid lesions with little associated mass effect and minimal or no surrounding vasogenic oedema. Calcification and cyst formation can occur, and contrast enhancement is generally present.
It should not be confused with dysplastic cerebellar gangliocytoma, which is also known as Lhermitte-Duclos disease.
They account for 0.1-0.5% of all brain tumours and occur in children and young adults.
Tumours in the cerebral cortex present most commonly with epilepsy.
The key feature is a lack of glial cells. The tumour is composed of abnormal mature ganglion cells.
Lack immunoreactivity to glial fibrillary acidic protein (GFAP).
Frequently associated with a dysplastic and malformed brain to varying degrees.
This tumour may arise anywhere within the neuroaxis. Occurs most frequently at the floor of the 3rd ventricle followed by the temporal lobe, cerebellum, parieto-occipital region, frontal lobe, and spinal cord.
Typically appears hyperattenuating on non contrast imaging.
Has little associated mass effect and minimal or no surrounding vasogenic oedema. Calcification and cyst formation can occur.
T1: solid components typically hypointense T2: solid components are typically mildly hypointense 2; cystic areas are hyperintense; calcification if present can be hypointense T1 C+ (Gd): solid components enhance Treatment and prognosis
They tend to grow slowly and do not undergo anaplastic change.
ganglioglioma cortical dysplasia dysembryoplastic neuroepithelial tumour (DNET)