MR imaging and histopathologic findings of a case of cerebral ganglioneurocytoma

Abstract

We report a case of ganglioneurocytoma manifesting as a complex partial seizure in a young adult male. MR images depicted a well-marginated cystic mass with a heterogeneous solid portion abutting the dura in the parietal lobe. The solid portion showed minimal heterogeneous enhancement, and pressure erosion of the overlying calvarium had occurred. Following gross total resection, the clinical outcome was satisfactory, with no further seizures, and during the five-year follow-up period, the tumor did not recur.

Fig. 1

A 23-year-old man with a longstanding history of seizure. A. T1-weighed (490/14) axial MR image depicts a large thin-walled cyst, isointense to CSF, in left parietal lobe white matter. The solid portion (arrows), located in the cortex, shaws relatively well-defined, heterogeneous mixed signal intensity. Erosion of the overlying calvarium (arrowhead) has occurred. B. In this T2-weighted (3500/99) axial MR image, the cystic portion isointense to CSF shows high signal intensity, while the solid portion shows heterogeneous high signal intensity (arrows). C. FLAIR (9999/119) image more clearly demonstrates the heterogeneous high signal intensity of the solid portion (arrows). D, E. Contrast-enhanced T1-weighed (490/14) axial (D) and sagittal (E) MR images show minimal enhancement of the solid portion (arrows). F. Photomicrograph (H & E staining, ×200) depicts ganglionic cells (arrows) among the small round cells. G. Photomicrograph (synaptophysin staining, ×200) reveals tumor cells embedded in a neurophil-like fibrillary background which is strongly immunoreactive for synaptophysin.