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Comparison of Patient Age with MR Imaging Features of Gangliogliomas

James M. Provenzale1, Unzila Ali2, Daniel P. Barboriak1, David F. Kallmes3, David M. Delong4 and Roger E. McLendon5

1 Department of Radiology, Neuroradiology Division, Duke University Medical Center, Box 3808, Durham, NC 27710-3808.
2 Duke University School of Medicine, 131 Davison Bldg., Duke University Medical Center, Box 3005, Durham, NC 27710.
3 Department of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA 22908.
4 Department of Community and Family Medicine, Biometry Division, Duke University Medical Center, Durham, NC 27710-3808.
5 Department of Pathology, Duke University Medical Center, Durham, NC 27710-3808.



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  		Fig. 1. —Ganglioglioma in 7-year-old boy with headaches. Unenhanced T1 weighted sagittal MR image shows inho mogeneous mass with hypointense cys tic components located in left ventricle This lesion, which measured 84 cm3, was representative of size of other tumors in early childhood group. Growth of tumo into lateral ventricle may have allowed tumor to attain large size with less mass effect on rest of brain than would be expected if tumor had been solely intra parenchymal. Smaller than expected mass effect could explain delay seen in patient's onset of symptoms (and delay in diagnosis) compared with mass of same size located solely in brain parenchyma.

 


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  		Fig. 2. —Ganglioglioma in 19-year-old woman with seizures. Contrast-en hanced T1-weighted axial MR image shows partially cystic enhancing mass (arrows) in right temporal lobe Lesion measured 5.15 cm3 and was representative of size of lesions seen in our adult group.

 


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  		Fig. 3. —Bar graph shows relationship between patient age and mean tumor size. Note marked difference between mean tumor size in two age groups, which met statistical significance (p = 0.001).

 


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  		Fig. 4. —Ganglioglioma in 1-year-old boy with left hemiparesis. Contrast-enhanced T1-weighted axial MR image shows predominantly cystic enhancing mass in right hemisphere. Tumor shown was largest in study, measuring 242 cm3. Note that right hemicranium is enlarged relative to left hemicranium because tumor growth occurred while cranial sutures were not yet fused. This factor may explain mass effect being less than expected on adjacent brain (and fewer neurologic deficits) than if sutures had been fused, which permitted tumor to attain large size before diagnosis.

 

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