Intracerebral ganglioglioma: clinical and radiological study of eleven surgically treated cases with follow-up.

BACKGROUND: Gangliogliomas are rare benign tumors of the CNS consisting of differentiated neural elements and low-grade glial cells. METHODS: We reviewed our experience of 11 patients with histologically proven ganglioglioma who were surgically treated since 1986 at Cukurova University Medical Center. These patients presented at 18 to 45 years of age. Five were women and six were men. The most common initial symptom was seizures (in nine of 11 patients), which had sometimes persisted over long periods of time. At the time of diagnosis, four patients had focal neurological deficits and three had signs or symptoms of increased intracranial pressure. The cystic and well-circumscribed characteristics of these lesions were detected on computed tomography (CT). Despite their appearance on CT, all but one of the lesions were found to be mostly solid at operation. Magnetic resonance imaging (MRI) in six patients revealed abnormally high signal intensity on T2-imaging. The temporal lobe was the main tumor location (seven patients). All cases were diagnosed according to the Russel and Rubinstein histological criteria for ganglioglioma. RESULTS: Ten patients had radical total resection and one had subtotal resection. No patient underwent postoperative radiation or chemotherapy. Except for one, all are still alive and free of progressive disease 1 to 11 years (mean 6.2) after operation. Six are seizure-free and three have improved seizure control under anticonvulsant therapy. CONCLUSIONS: We conclude that ganglioglioma is a distinct histological phenomenon with mildly predictable clinical symptoms (seizures), mildly characteristic radiological features, and long-term survival after surgical resection without the need of adjuvant treatment such as radiotherapy.

Intracranial intraosseous hydatid cyst. Case report and review of literature.

Cerebral hydatidosis accounts for approximately 1 to 3% of all cases of hydatid disease. Generally, cerebral hydatid cysts are single lesions located in the watershed of the middle cerebral artery. Primary intracranial extracerebral hydatid cysts are extremely rare. Only 2% of hydatid cysts are localized in the skeleton, and of these 3 to 4% are found in the skull. The authors describe the case of a 10-year-old boy who was admitted to their clinic with headache and unilateral focal epileptic seizures. Computerized tomography scanning revealed a right parietal intraosseous hydatid cyst. A case of cranial intraosseous hydatid disease is presented, and the differential diagnosis and treatment are discussed in the light of literature.