Skip to main content

Advertisement

SpringerLink
Log in

Radiological Evaluation of Infratentorial Gangliogliomas in Various Anatomic Locations of the Cerebellum and Brainstem

  • Original Article
  • Published:
Clinical Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

To review the imaging features of infratentorial gangliogliomas (GGs) and compare between Infratentorial GGs located within the cerebellum and brainstem.

Methods

The cases of 24 patients with histologically-confirmed infratentorial GGs were reviewed retrospectively. These subjects’ cases were divided into a cerebellar group (n = 8) and a brainstem group (n = 16) based upon the anatomic location of the tumor. Imaging features (including tumor volume, margins, cystic/solid ratio, enhancement, peritumoral edema, and ipsilateral cerebellar atrophy) were compared between these two groups.

Results

On magnetic resonance imaging, infratentorial GGs showed isointensity or hypointensity on T1WI and heterogeneous hyperintensity on T2WI, with ipsilateral cerebellar atrophy observed in seven cases. Computed tomography images available in the cerebellar group showed heterogeneous isodensity with calcifications. Cerebellar GGs (median = 67.25 cm3, inter-quartile range = 27.78–83.27 cm3) were larger in volume than brainstem GGs (median = 16.89 cm3, interquartile range = 6.08–27.26 cm3) (p = 0.002). Cystic-solid mass (5 of 8) and solid mass (11 of 16) were more commonly represented in the cerebellar and brainstem group, respectively (p = 0.033). Cerebellar GGs showed varying degrees of enhancement, while most of brainstem GGs showed moderate-to-marked enhancement (p = 0.012). Dorsal-predominant enhancement (n = 3) and posterior-marginal enhancement (n = 5) were observed in the brainstem group. The degrees of peritumoral edema and rate of ipsilateral cerebellar atrophy were not significantly different between the two study groups.

Conclusion

Ipsilateral cerebellar atrophy can be found in infratentorial GGs involving the middle and inferior cerebellar peduncles. GGs should therefore be considered in the differential diagnoses when a solid-cystic mass with calcification is encountered in the cerebellum. Brainstem GGs tend to be smaller, solid masses with moderate-to-marked enhancement. Dorsal-predominant and posterior-marginal enhancement may be the specific imaging findings for brainstem GGs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Qin B, Tabbara AK, Delalle I, Holsapple J, Hohler A. An enigmatic brainstem posterior fossa ganglioglioma in an adult. Int J Neurosci. 2014;124(9):704–6.

    Article  PubMed  Google Scholar 

  2. Saad AF, Layton KF, Finn SS, Opatowsky MJ. Ganglioglioma and migraine headache. Proc (Bayl Univ Med Cent). 2014;27(3):215–6.

    Google Scholar 

  3. Deipolyi A, Auguste KI, Yang I, Tihan T, Parsa AT. Occipital ganglioglioma in an older adult. J Clin Neurosci. 2010;17(11):1459–61.

    Article  PubMed  Google Scholar 

  4. Uchida K, Nakayama H, Endo Y, Kai C, Tatewaki S, Yamaguchi R, Doi K, Tateyama S. Ganglioglioma in the thalamus of a puppy. J Vet Med Sci. 2003;65(1):113–5.

    Article  PubMed  Google Scholar 

  5. Rolston JD, Han SJ, Cotter JA, El-Sayed IH, Aghi MK. Gangliogliomas of the optic pathway. J Clin Neurosci. 2014;21(12):2244–9.

    Article  PubMed  Google Scholar 

  6. Tender GC, Smith RD. Pineal ganglioglioma in a young girl: a case report and review of the literature. J La State Med Soc. 2004;156(6):316–8.

    PubMed  Google Scholar 

  7. Deling L, Nan J, Yongji T, Shuqing Y, Zhixian G, Jisheng W, Liwei Z. Intraventricular ganglioglioma prognosis and hydrocephalus: the largest case series and systematic literature review. Acta Neurochir (Wien). 2013;155(7):1253–60.

    Article  Google Scholar 

  8. Enomoto T, Fukushima Y, Yoshino S, Hirakawa K, Fukushima T, Aoki M, Nabeshima K, Tsugu H, Inoue T. A case of ganglioglioma extended to the lateral ventricle and associated with neurofibromatosis type 1. No Shinkei Geka. 2015;43(2):147–52.

    PubMed  Google Scholar 

  9. Murakami T, Koyanagi I, Kaneko T, Yoneta A, Keira Y, Wanibuchi M, Hasegawa T, Mikuni N. Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings: case report. J Neurosurg Spine. 2013;18(2):184–8.

    Article  PubMed  Google Scholar 

  10. Zhang S, Wang X, Liu X, Ju Y, Hui X. Brainstem gangliogliomas: a retrospective series. J Neurosurg. 2013;118(4):884–8.

    Article  PubMed  Google Scholar 

  11. Kim SD, Kim JH, Lee CY, Kim HW. Ganglioglioma in brainstem: case report and a review of literatures. J Korean Neurosurg Soc. 2014;55(3):164–6.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hanai S, Okazaki K, Fujikawa Y, Nakagawa E, Sugai K, Sasaki M, Otsuki T. Hemifacial seizures due to ganglioglioma of cerebellum. Brain Development. 2010;32(6):499–501.

    Article  PubMed  Google Scholar 

  13. Jeevan DS, Neil JA, Mohan A, Tobias M. Hemorrhagic ganglioglioma of the posterior fossa: case report. Pediatr Neurosurg. 2013;49(1):33–7.

    Article  PubMed  Google Scholar 

  14. Fedoul B, Souirti Z. Cerebellar ganglioglioma. Pan Afr Med J. 2012;12(1):12.

    PubMed  PubMed Central  Google Scholar 

  15. Gurkanlar D, Kocak H, Yucel E, Aciduman A, Gunaydin A, Ekinci O, Keskil S. Ganglioglioma with lytic skull lesions: a case report. Neurocirugia (Astur). 2007;18(2):123–7.

    Article  CAS  Google Scholar 

  16. Lindsay AJ, Rush SZ, Fenton LZ. Pediatric posterior fossa ganglioglioma: unique MRI features and correlation with BRAF V600E mutation status. J Neurooncol. 2014;118(2):395–404.

    Article  PubMed  Google Scholar 

  17. James K, Eisenhauer E, Christian M, Terenziani M, Vena D, Muldal A, Therasse P. Measuring response in solid tumors: unidimensional versus bidimensional measurement. J Natl Cancer Inst. 1999;91(6):523–8.

    Article  CAS  PubMed  Google Scholar 

  18. Zhang D, Henning TD, Zou LG, Hu LB, Wen L, Feng XY, Dai SH, Wang WX, Sun QR, Zhang ZG. Intracranial ganglioglioma: clinicopathological and MRI findings in 16 patients. Clin Radiol. 2008;63(1):80–91.

    Article  CAS  PubMed  Google Scholar 

  19. Yi KS, Sohn CH, Yun TJ, Choi SH, Kim JH, Han MH, Park CK, Park SH, Chang KH. MR imaging findings of extraventricular neurocytoma: a series of ten patients confirmed by immunohistochemistry of IDH1 gene mutation. Acta Neurochir (Wien). 2012;154(11):1973–79.

    Article  Google Scholar 

  20. Lagares A, Gómez PA, Lobato RD, Ricoy JR, Ramos A, de la Lama A. Ganglioglioma of the brainstem: report of three cases and review of the literature. Surg Neurol. 2001;56(5):315–22.

    Article  CAS  PubMed  Google Scholar 

  21. Park SH, Kim E, Son EI. Cerebellar ganglioglioma. J Korean Neurosurg Soc. 2008;43(3):165–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Yin L, Zhang L. Correlation between MRI findings and histological diagnosis of brainstem glioma. Can J Neurol Sci. 2013;40(3):348–54.

    Article  PubMed  Google Scholar 

  23. Law M, Meltzer DE, Wetzel SG, Yang S, Knopp EA, Golfinos J, Johnson G. Conventional MR imaging with simultaneous measurements of cerebral blood volume and vascular permeability in ganglioglioma. Magn Reson Imaging. 2004;22(5):599–606.

    Article  PubMed  Google Scholar 

  24. Lou X, Gui QP, Sun L, Wu NZ, Lyu JH, Ma L. Comparisons of MR findings between supratentorial and infratentorial gangliogliomas. Clin Neuroradiol. 2014 Aug 23. [Epub ahead of print]

  25. Mah S, deVeber G, Wei XC, Liapounova N, Kirton A. Cerebellar atrophy in childhood arterial ischemic stroke: acute diffusion MRI biomarkers. Stroke. 2013;44(9):2468–74.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, 100050, Beijing, China

    S. Zhang, X. Z. Chen & K. Wang

  2. Departments of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, 100050, Beijing, China

    L. Ai

Authors
  1. S. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Ai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. X. Z. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Ai.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, S., Ai, L., Chen, X.Z. et al. Radiological Evaluation of Infratentorial Gangliogliomas in Various Anatomic Locations of the Cerebellum and Brainstem. Clin Neuroradiol 27, 319–327 (2017). https://doi.org/10.1007/s00062-015-0495-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00062-015-0495-7

Keywords

Search

Navigation