Cent Eur Neurosurg 2011; 72(4): 196-200
DOI: 10.1055/s-0031-1275287
Review

© Georg Thieme Verlag KG Stuttgart · New York

Ganglioglioma of the Right Lateral Ventricle Approached with Neuronavigation and Intraoperative DTI. Case Report and Literature Review.

G. d’Andrea1 , G. Sessa1 , L. Ferrante2
  • 1S Andrea Hospital, University of Rome , Neurosurgery, Rome, Italy
  • 2S Andrea Hospital, Neurosciences, Rome, Italy
Further Information

Publication History

Publication Date:
12 October 2011 (online)

Abstract

Background and study object: We describe the case of a young patient treated for a ganglioglioma of the right lateral ventricle. The ganglioma was approached via a temporal route using neuronavigation. Such lesions, if confined to the ventricular system and, especially, to the lateral ventricle, are unusual.

Case Report: A 22-year-old male was admitted because of headache and seizures. Magnetic resonance imaging (MRI) revealed a neoplasm in the temporal horn of the right lateral ventricle. A CT scan demonstrated calcifications. After preoperative planning, the patient was scheduled for neuronavigated operation. A small temporal craniotomy was performed. Once the dura was opened, we acquired a volumetric intraoperative MRI with diffusion tensor imaging (DTI). The optic tract was visualized again on intraoperative DTI and the volumetric MRI was used to update the navigational data.

Results: The temporal corticotomy between the inferior and the middle temporal gyrus was guided by neuronavigation, keeping the surgical corridor in distance to the optic tract until the tumor was reached. After tumor resection, we repeated intraoperative MRI with DTI, which confirmed complete tumor removal and the patency of the optic pathway. Our protocol allowed us to reach the lesion via a minimally invasive approach with near real-time control of the integrity of the optic tract during surgery. DTI was acquired preoperatively and during surgery, avoiding inaccuracy due to brain shift.

Conclusions: Intraoperative MRI with DTI allows to treat such lesions via minimally invasive approaches and to reduce operative morbidity due to fiber tract damage.

References

  • 1 Basser PJ, Pajevic S, Pierpaoli C. et al . In vivo fiber tractography using DT-MRI data.  Magn Reson Med. 2000;  44 625-632
  • 2 Bhat DI, Mahadevan A, Manish R. et al . Intraventricular ganglioglioma with bleed: a rare case report.  Neurol India. 2010;  58 477-480
  • 3 Berenguer N, Bargallo N, Bravo E. et al . An unusual frontal ganglioglioma: CT and MRI.  Neuroradiol. 1994;  36 311-312
  • 4 Burgel U, Madler B, Honey CR. et al . Fiber tracking with distinct software tools results in a clear diversity in anatomical fiber tract portrayal.  Cen Eur Neurosurg. 2009;  70 27-35
  • 5 Castillo M, Davis PC, Takei Y. et al . Intracranial ganglioglioma: MR, CT and clinical findings in 18 patients.  AJNR Am J Neuroradiol. 1990;  11 109-114
  • 6 Chen X, Weigel D, Ganslandt O. et al . Prediction of visual field deficits by diffusion tensor imaging in temporal lobe epilepsy surgery.  Neuroimage. 2009;  45 286-297
  • 7 Committee of Brain Tumor Registry of Japan.  Report of Brain Tumor Registry of Japan (1969–1996), 11th ed. Neurol Med Chir (Tokyo). 2003;  43 (Suppl. i–iv) 1-111
  • 8 Courville CB. Ganglioglioma: tumor of the central nervous system: review of the literature and report of two cases.  Arch Neurol Psychiatry. 1930;  24 (3) 439-491
  • 9 Demaerel P, Droessaert M, Lammens M. et al . Anaplastic (malignant) ganglioglioma arising from heterotopic grey matter nodules.  J Neurooncol. 1996;  30 237-242
  • 10 Demierre B, Stichnot FA, Hori A. et al . Intracerebral ganglioglioma.  J Neurosurg. 1986;  65 177-182
  • 11 Diepholder HM, Schwechheimer K, Mohadjer M. et al . A clinicopathologic and immunomorphologic study of 13 cases of ganglioglioma.  Cancer. 1991;  68 (10) 2192-2201
  • 12 Doyle JB, Kernohan JW. Ganglioneuroma of the third ventricle with diabetes insipidus and hypopituitarism.  J Nerv Ment Dis. 1931;  73 55-61
  • 13 Ewing J. Neoplastic Diseases. Philadelphia: W.B. Saunders Company; 1928: 26
  • 14 Hashimoto M, Fujimoto K, Shinoda S. et al . Magnetic resonance imaging of ganglion cell tumors.  Neuroradiol. 1993;  35 181-184
  • 15 Hauck EF, Vu L, Campbell GA. et al . Intraventricular ganglioglioma.  J Clin Neurosci. 2008;  15 1291-1293
  • 16 Im SH, Chung CK, Cho BK. et al . Intracranial ganglioglioma: preoperative characteristics and oncologic outcome after surgery.  J Neuroncol. 2002;  59 173-183
  • 17 Jaeger M, Hussein S, Schuhmann MU. et al . Intraventricular trigonal ganglioglioma arising from the choroid plexus.  Acta Neurochir (Wien). 2001;  143 (9) 953-955
  • 18 Johannsson JH, Rekate HL, Roessmann U. Gangliogliomas: pathological and clinical correlation.  J Neurosurg. 1981;  54 58-63
  • 19 Kalyan-Raman UP, Olivero WC. Ganglioglioma: a correlative clinicopathological and radiological study of ten surgically treated cases with follow-up.  Neurosurgery. 1987;  20 428-433
  • 20 Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumors.  Brain Pathol. 1993;  3 255-268
  • 21 Krouwer HG, Davis RL, McDermott MW. et al . Gangliogliomas: a clinicopathological study of 25 cases and review of the literature.  J Neur Oncol. 1993;  17 139-154
  • 22 Lang FF, Epstein FJ, Ransohoff J. et al . Central nervous system gangliogliomas. Part 2: clinical outcome.  J Neurosurg. 1993;  79 867-873
  • 23 Levesque MF, Meagher-Villemure K, Dubeau F. et al . Cerebral gangliogliomas – review of 24 cases.  Can J Neurol Sci. 1986;  13 284
  • 24 Luyken C, Blumcke I, Fimmers R. et al . Supratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years.  Cancer. 2004;  101 (1) 146-155
  • 25 Majos C, Aguilera C, Ferrer I. et al . Intraventricular ganglioglioma: case report.  Neuroradiology. 1998;  40 (6) 377-379
  • 26 Matsumoto K, Tamiya T, Ono Y. et al . Cerebral gangliogliomas: clinical characteristics, CT, and MRI.  Acta Neurochir (Wien). 1999;  141 135-141
  • 27 Miller DC, Lang FF, Epstein FJ. Central nervous system gangliogliomas. Part 1: pathology.  J Neurosurg. 1993;  79 859-866
  • 28 Mori S, Van Zjil PC. Fiber tracking principles and strategies – a technical review.  NMR Biomed. 2002;  15 468-480
  • 29 Nanassis K, Tsitsopoulos PP, Marinopoulos D. et al . Long-term follow-up of a non-infantile desmoplastic ganglioglioma.  Cen Eur Neurosurg. 2010;  71 (1) 50-53
  • 30 Nimsky C, Von Keller B, Schlaffer S. et al . Updating navigation with intraoperative image data.  Top Magn Reson Imaging. 2008;  19 (4) 197-204
  • 31 Nishio S, Morioka T, Mihara F. et al . Cerebral ganglioglioma with epilepsy: neuroimaging features and treatment.  Neurosurg Rev. 2001;  24 14-19
  • 32 Rossi E, Vaquero J, Martinez R. et al . Intracranial ganglioglioma.  Acta Neurochir (Wien). 1984;  71 255-261
  • 33 Romano A, D’Andrea G, Minniti G. et al . Pre-surgical planning and MR-tractography utility in brain tumor resection.  Eur Radiology. 2009;  19 2798-2808
  • 34 Russell DS, Rubinstein LJ. Ganglioglioma: a case with long history and malignant evolution.  J Neuropathol Exp Neurol. 1962;  21 185-193
  • 35 Russell DS, Rubinstein LJ. Pathology of tumors of the nervous system.. 4th ed. Baltimore: Williams and Wilkins; 1962: 262-268
  • 36 Samdani AF, Torre-Healy A, Khalessi A. et al . Intraventricular ganglioma: A short illustrated review. Acta Neuroch (Wien).  . 2009;  151 635-640
  • 37 Shono T, Tosaka M, Matsumoto K. et al . Ganglioglioma in the third ventricle: report on two cases.  Neurosurg Rev. 2007;  30 (3) 253-258 ; discussion 258
  • 38 Silver JM, Rawlings CE, Rossitch E. et al . Ganglioglioma: a clinical study with long-term follow-up.  Surg Neurol. 1991;  35 261-266
  • 39 Stieltjes B, Kaufmann WE, Van Zjil PC. et al . Diffusion tensor imaging and axonal tracking in the human brainstem.  Neuroimage. 2001;  14 723-735
  • 40 Tampieri D, Moumdijan R, Melanson D. et al . Intracerebral gangliogliomas in patients with partial complex seizures: CT and MR imaging findings.  AJNR. 1991;  12 749-755
  • 41 Tatter SB, Wilson CB, Harsh IV GR. Neuroepithelial tumors of the adult brain.. Neurological Surgery Philadelphia: W.B. Saunders Company; 1996: 2665-2666
  • 42 Yin Foo Lee G, Scott G, Blumbergs PC. et al . Ganglioglioma of the lateral ventricle presenting with blepharospasm – case report and review of the literature.  J Clin Neurosci. 2001;  8 (3) 279-282
  • 43 Yu CS, Li KC, Xuan Y. et al . Diffusion tensor tractography in patients with cerebral tumors: a helpful technique for neurosurgical planning and postoperative assessment.  Eur J Radiology. 2005;  56 197-204
  • 44 Zentner J, Wolf HK, Ostertun B. et al . Gangliogliomas: clinical, radiological, and histopathological findings in 51 patients.  J Neurol Neurosurg Psychiatry. 1994;  57 1497-1502
  • 45 Zulch KJ. Histological typing of tumors of the central nervous system.. International Classification of Tumors No. 21 World Health Organization, Geneva; 1979: 43-52

Correspondence

G. d’AndreaMD 

S Andrea Hospital

University of Rome

Neurosurgery

via grottarossa 1035

00100 Rome

Italy

Phone: +30/633/775 487

Fax: +39/633/775 896

Email: gdandrea2002@yahoo.it