Ganglioglioma in the third ventricle: report on two cases (original) (raw)

Abstract

Gangliogliomas are uncommon central nervous system (CNS) tumors composed of a mixture of glial and neuronal elements. Although these tumors can occur in any portion of the central nervous system, involvement of the ventricular system is rare. We herein report on two cases of gangliogliomas in the third ventricle in a 34-year-old woman and in a 52-year-old man. One patient presented only with headaches, and the other presented symptoms associated with panhypopituitarism and diabetes insipidus. In the first case the tumor in the middle portion of the third ventricle was successfully removed by a transcallosal subchoroidal approach. In the second case the hemorrhagic tumor was located in the anterior floor of the third ventricle and was removed by an anterior inter-hemispheric trans-lamina terminalis approach. To date, follow-ups of both patients have involved no adjuvant therapy, and there have been no signs of tumor recurrence on magnetic resonance images. The nature, radiological findings, and treatments of these tumors are discussed.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
    Tadahisa Shono, Kenichi Matsumoto, Sadao Onaka, Shinya Yamaguchi, Masahiro Mizoguchi & Tomio Sasaki
  2. Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
    Toru Iwaki
  3. Department of Neurosurgery, Gunma University School of Medicine, Maebashi, Japan
    Masahiko Tosaka
  4. Department of Neuropathology, Gunma University School of Medicine, Maebashi, Japan
    Yoichi Nakazato

Authors

  1. Tadahisa Shono
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  2. Masahiko Tosaka
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  3. Kenichi Matsumoto
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  4. Sadao Onaka
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  5. Shinya Yamaguchi
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  6. Masahiro Mizoguchi
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  7. Toru Iwaki
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  8. Yoichi Nakazato
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  9. Tomio Sasaki
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Corresponding author

Correspondence toTadahisa Shono.

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Comments

Josef Zentner, Freiburg, Germany

Gangliogliomas are rare but well-known lesions that account for almost 1% of all brain tumors, with a higher incidence in infancy. Most patients present with a long history of seizures, whereas focal neurological deficits or increased intracranial pressure are unusual. The temporal lobe is the most common location of gangliogliomas. However, gangliogliomas may occur at virtually any location in the CNS, such as the spinal cord, brainstem, third and fourth ventricle, cerebellum, pineal region, thalamus and optic nerve. The authors present two cases of gangliogliomas in the third ventricle. Although the occurrence of gangliogliomas in this location has, as mentioned above, already been described, it seems useful to point again to an unusual location of this rare histopathological entity. This is particularly true, since gangliogliomas in this location may be included in the differential diagnosis of lesions causing diabetes insipidus and hypopituitarism.

Kazuhiko Nozaki, Kyoto, Japan

The authors reported two cases of ganglioglioma in the third ventricle in which surgical resection was performed successfully by fine microsurgical techniques. Exophytic growth of tumors in two cases made it possible to perform total removal without neurological deficits in the regions adjacent to vital structures such as the thalamus and hypothalamus, although histological total resection was not described in the manuscript. There may have been a histological residual lesion, particularly in case 2, since the lesion was poorly demarcated. Neuroendoscopic surgery is another option for histological confirmation or third vetriculostomy in patients with no or minor neurological symptoms or hydrocephalus. Although surgical indication depends on several factors, such as patient’s age, symptoms, location of the lesion and surgeon’s skills, total resection is a recommended option if the lesion is accessible and can be removed without complications.

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Shono, T., Tosaka, M., Matsumoto, K. et al. Ganglioglioma in the third ventricle: report on two cases.Neurosurg Rev 30, 253–258 (2007). https://doi.org/10.1007/s10143-007-0090-8

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