Description
A 55-year-old woman with left-side weakness and progressive confusion
55岁女性，左侧肢体无力，意识模糊逐渐加重。
Noncontrast CT scan (A) demonstrates a heterogeneous lesion involving both the frontal lobes. Calcification is seen within this lesion. Axial T2WI (B) and contrast-enhanced sagittal T1WI (C) demonstrate a heterogeneously enhancing lesion involving both frontal lobes and extending across the anterior body of the corpus callosum. Axial DSC-perfusion MRI (D) demonstrates increased perfusion from the lesion. H&E stain (E) confirms the diagnosis . Malignant transformation was seen on pathology.
CT平扫示双侧额叶可见不均质肿块，内可见钙化。
横断位T2WI及矢状位增强T1WI示病灶通过胼胝体前部跨越中心累及双侧额叶，增强扫描肿块不均匀强化。
横断位动态磁敏感对比增强(dynamic susceptibility weighted contrast enhanced,DSC)灌注加权像示病灶内灌注增加。
H&E stain (E) confirms the diagnosis . Malignant transformation was seen on pathology.
H&E染色证实神经节胶质瘤诊断，并可见恶变征象。
Ganglioglioma with Malignant Transformation
神经节胶质瘤恶变
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Gangliogliomas are glioneuronal tumors of central nervous system, affecting mainly children and young adults. Malignant transformation is rarely seen.
神经节胶质瘤是来源于中枢神经系统神经胶质的一类肿瘤，常累及儿童和青少年，恶变罕见。
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Clinical Presentation: Chronic epilepsy refractory to medication.
临床表现：长期癫痫，药物治疗效果不佳。
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Common location: Cortical superficial location within the cerebral hemispheres, predilection for the frontal and temporal lobes. Other uncommon sites are reported.
好发部位：大脑半球皮层区，特别是额叶和颞叶。其他少见部位也有报道。
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The classic appearance of ganglioglioma is a cystic lesion with a solid enhancing mural nodule, often calcified. “Bizarre” patterns of calcification can be seen.
神经节胶质瘤典型表现为囊性病变伴实性壁结节，常可见钙化，钙化形态不规则。
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Pleomorphic xanthoastrocytoma
多形性黄色星形细胞瘤
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Pilocytic astrocytoma
纤维性星形细胞瘤
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Oligodendroglioma
少突胶质细胞瘤
Rx
Surgical resection
手术切除