engleski

Ganglioglioma anaplasticum

Background. – Ganglioglioma is an uncommon benign brain tumor consisting of ganglionic and glial cells. Five per cent of cases have malignant features and they are designed as anaplastic ganglioglioma. The present case report describes a case of ganglioglioma with an anaplastic component in the region of the pineal gland of a 67-yer-old man who presented initially with a World Health Organization grade III ananplastic ganglioglioma. Clinical summary. – A 67-year-old man was admitted to hospital because of headache, fatigue, weakness of audial and visual perception and walking instability. This patient was suffering from diabetes type II and hypertension. Neurological examination on admission revealed disorientation (GCS=14), immobile without help and discret Parynaud syndrom without lateralization. Magnetic resonance imaging disclosed a solid mass (3x2cm) in the posterior part of third ventricul and in the region of the pineal gland. The solid mass was surgically removed. Results. - The resected tissue measured 0.6cm. Histologically, the tumor tissue showed remarkable cellular pleomorphism consisted of small oval hyperchromatic cells and multinucleated giant cells. In one area, the tumor tissue was lobulated and the tumor cells were separated with a mass of connective tissue, and in the other area, perivascular reticulin fibers surrounding fields of the tumor cells were seen. The majority of the tumor cells were GFAP positive and NSE positive. Synaptophysin immunoreactivity was present in the large multinucleated cells. More than 25 % of tumor cells were Ki67 positive. Conclusion. The current case represents a very rare malignant variation of ganglioglioma.

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