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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2022; 80(01): 101-102
DOI: 10.1590/0004-282X-ANP-2021-0261
Images in Neurology

A rare case of intraventricular gangliocytoma

Um caso raro de gangliocitoma intraventricular
João Antonio Pessôa Corrêa 
1   Universidade Federal de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil.
,
Lucas Teixeira Diniz 
1   Universidade Federal de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil.
,
João Norberto Stavale 
2   Universidade Federal de São Paulo, Departamento de Patologia, São Paulo SP, Brazil.
,
Felipe Campos Kitamura 
1   Universidade Federal de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil.
,
Luis Antonio Tobaru Tibana 
1   Universidade Federal de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil.
,
Márcio Luís Duarte 
3   Universidade Federal de São Paulo, Departamento de Saúde Baseada em Evidências, São Paulo SP, Brazil.
,
Leonardo Furtado Freitas 
1   Universidade Federal de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil.
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A 49-year-old man presented to the emergency department after cranioencephalic trauma with an intraventricular tumor detected in the computed tomography (CT) scan ([Figure 1]). An magnetic resonance image (MRI) showed a heterogeneous expansive lesion with enhancing solid components and peripheral cysts located in the left lateral ventricle ([Figure 1]). The patient underwent excision of the lesion. Histopathologic ([Figure 2]) and immunohistochemical ([Figure 3]) analysis revealed the diagnosis of gangliocytoma. Gangliocytomas are rare low-grade central nervous system tumors composed of dysplastic ganglion cells, usually presenting in children or young adults and located in the cerebral hemispheres[1],[2]. Until now, there are no case reports of intraventricular gangliocytoma.

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Figure 1 Coronal (A) and axial (B) nonenhanced brain CT shows a solid and cystic lesion within the lateral left ventricle and infiltrating adjacent white matter. Coronal and axial T2 (C, D), axial FLAIR (E) shows a well-demarcated, isointense and heterogeneous lesion with predominantly peripheral cysts located within the left lateral ventricle with infiltration of its lateral wall and the septum pellucidum. Sagittal and axial post-contrast T1 (F, G) sequence shows intense enhancement of the solid portion and increased rCBV on DSC perfusion (H).FLAIR: fluid attenuated inversion recovery; rCBV: relative cerebral blood volume; DSC: differential scanning calorimetry.
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Figure 2 Clusters of atypical pleomorphic ganglion cells embedded in a haphazard manner within a delicate neuropil matrix. No neoplastic glial cells are present.
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Figure 3 Immunohistochemical (IHC) studies. Glial fibrillary acidic protein (GFAP) positive in normal astrocytes with positive ATRX and negative isocitrate dehydrogenase. Neurofilament (NF) and synaptophysin (SYN) were positive in the neuropil. Ki-67 (Ki67), which determines the proliferative index, was low (< 2%).

Authors’ contributions:

JAPC, LTD: JNS, FCK, LFF: manuscript composition; LATT, MLD: manuscript review.




Publication History

Received: 03 July 2021

Accepted: 08 August 2021

Article published online:
30 January 2023

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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