Ganglioglioma: comparison with other low-grade brain tumors

Abstract

-Method: F o rty-two patients with low-grade brain tumor and re f r a c t o ry epilepsy were studied. The mean age was 22.3 years. They were divided into two groups: Group A, patients with ganglioglioma (n=19) and group B, patients with other low-grade tumors (n=23) (14 astrocytoma, 6 oligodend roglioma, 2 dysembryoplastic neuroepithelial tumor, and 1 xanthoastro c y t o m a ) . Results: Age at seizure 's onset was 7 years or less in 73% of the patients in group A and in 30.4% of the patients in group B (p=0.045). Complex partial occurred frequently in group A and B (94.7% versus 82%, respectively). Seizure 's fre q u e ncy was higher in group B (p=0.002).Computerized tomography (CT) was normal in 36.8% of group A patients and abnormal in all group B patients. Magnetic resonance imaging (MRI) was abnormal in all patients. S u rgical removal was complete in 89.5% of the patients in group A and in 78.2% of the patients in gro u p B . Conclusion: The association of re f r a c t o ry epilepsy and complex partial seizures, at a relatively low freq u e n c y, in young patients potentially normal CT and a MRI hypointense temporal lobe lesion in T1-weighed slices were habitual image findings in ganglioglioma, rather than other low-grade tumor.KEY WORDS: ganglioglioma, refractory epilepsy, low-grade brain tumors.Ganglioglioma: estudo comparativo com outros tumores cerebrais primarios de baixo grau RESUMO -Método: Foram estudados 42 pacientes com tumor cerebral primário de baixo grau e epilepsia refratária. A idade média foi 22,3 anos. Eles foram divididos em dois grupos: no grupo A os pacientes com ganglioglioma (n=19) e no grupo B os pacientes com outros tumores primários de crescimento lento (n=23) (14 astrocitomas, 6 oligodendrogliomas, 2 tumores desembrioblástico neuroepitelial e um xantoastro c i t om a ) . Resultados: A idade de início das crises convulsivas foi 7 anos ou menos em 73% dos pacientes no g rupo A e 30,4% dos pacientes no grupo B (p=0,045). A crise convulsiva do tipo parcial complexa foi a mais identificada nos grupos A e B (94,7% versus 82%, respectivamente). A freqüência de crise foi mais alta no g rupo B (p=0,002). A tomografia computadorizada foi normal em 36,8% dos pacientes no grupo A e anormal em todos no grupo B. A ressonância magnética foi anormal em todos os pacientes. A remoção cirúr-gica foi completa em 89.5% dos pacientes no grupo A e 78,2% no grupo B. Conclusão: A associação de epilepsia refratária e crise parcial complexa, principalmente quando a freqüência não é muito alta, em pacientes jovens, mesmo com tomografia computadorizada normal e alteração hipointensa na seqüência de T1 da ressonância magnética é sugestiva de ganglioglioma mais que outros tipos de tumor cere b r a l primário de baixo grau. PALAVRAS-CHAVE: ganglioglioma, epilepsia refratária, tumor cerebral de baixo grau.Ganglioglioma (GG) is one of the commonest causes of tumor-related re f r a c t o ryepilepsy in young pat i e n t s 1 , and together with other low-grade brain neop l a s m 's, comprises 10-30% of the ...

Tumor recurrence and malignant progression of gangliogliomas

“…Older age also has been associated with an adverse prognosis by other authors 20. It was suggested that anaplastic GGs occur more often in older patients compared with their nonmalignant counterparts 5, 17, 19, 32…”

Early surgical intervention in adult patients with ganglioglioma is associated with improved clinical seizure outcomes

“…2,3,5,7,14 Favorable seizure control has also been correlated with factors such as younger age at surgery, epilepsy characterized by lack of secondary generalized or grand mal seizures, presence of large nerve cells in the tumor, and post-operative absence of epileptiform discharges. 6,14,32 Our analysis further suggests that in the adult population, an earlier surgical intervention from onset of symptoms and diagnosis is associated with improved clinical seizure outcomes.…”

“…These central nervous system tumors occur most commonly in children and young adults, with a mean age at surgical intervention of approximately 20 years. [1][2][3][4][5] Most tumors arise from the supratentorial cerebral hemispheres and have a strong predilection for the temporal lobe, with most GG occurring at this location. 1,[6][7][8] However, GG can be found throughout the central nervous system and have been reported less frequently in regions such as the cerebellum, spinal cord, optic nerves, trigeminal nerve, basal ganglia, thalamus, hypothalamus, and ventricles.…”

Epilepsy-associated tumours: what epileptologists should know about neuropathology, terminology, and classification systems

“…It is also puzzling and difficult to understand why there are such different percentages of LEAT subtypes in published surgical series, which some authors refer to as “geographical differences” ( see review of Thom et al ., ). The majority of publications on epilepsy‐associated brain tumours specify GGs as the most frequent tumour type, followed by DNTs and PAs (Khajavi et al ., ; Luyken et al ., ; Zaatreh et al ., ; Brainer‐Lima et al ., ; Schramm and Aliashkevich, ; Sugano et al ., ; Ruban et al ., ; Prayson, ; Garcia‐Fernandez et al ., ; Babini et al ., ; Cossu et al ., ; Rydenhag et al ., ; Fallah et al ., ; Bonney et al ., , ). However, even in large series, the frequency of GGs can vary from 6% to 49%, and for DNTs from even 7% to 80% (Thom et al ., ).…”