Brainstem gangliogliomas: a retrospective series

Clinical article

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The authors retrospectively analyzed data on brainstem gangliogliomas treated in their department and reviewed the pertinent literature to foster understanding of the preoperative characteristics, management, and clinical outcomes of this disease.


In 2006, the authors established a database of treated lesions of the posterior fossa. The epidemiology findings, clinical presentations, radiological investigations, pathological diagnoses, management, and prognosis for brainstem gangliogliomas were retrospectively analyzed.


Between 2006 and 2012, 7 patients suffering from brainstem ganglioglioma were treated at the West China Hospital of Sichuan University. The mean age of the patients, mean duration of symptoms prior to diagnosis, and mean duration of follow-up were 28.6 years, 19.4 months, and 38.1 months, respectively. The main presentations were progressive cranial nerve deficits and cerebellar signs. Subtotal resection was achieved in 2 patients, and partial resection in 5. All tumors were pathologically diagnosed as WHO Grade I or II ganglioglioma. Radiotherapy and adjuvant chemotherapy were not administered. After 21–69 months of follow-up, patient symptoms were resolved or stable without aggravation, and MRI showed that the size of residual lesions was unchanged without progression or recurrence.


The diagnosis of brainstem ganglioglioma is of great importance given its favorable prognosis. The authors recommend the maximal safe resection followed by close observation without adjuvant therapy as the optimal treatment for this disease.

Abbreviation used in this paper:GFAP = glial fibrillary acidic protein.

Article Information

Address correspondence to: Xuhui Hui, Ph.D., Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Wu Hou District, Chengdu, 610041, People's Republic of China. email:

Please include this information when citing this paper: published online February 1, 2013; DOI: 10.3171/2013.1.JNS121323.

© AANS, except where prohibited by US copyright law.



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    Magnetic resonance images showing different patterns of enhancement of brainstem gangliogliomas. The tumor in Case 1 (A) enhanced homogeneously with an associated cyst after administration of Gd. The tumor in Case 2 (B) enhanced heterogeneously. The tumors in Cases 4 (C) and 7 (D) did not enhance after administration of Gd.

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    Case 3. Preoperative MR images showing a lesion in the medulla and middle cerebellar peduncle with hypointensity on a T1-weighted sequence (A) and hyperintensity on a T2-weighted sequence (B). No enhancement is observed after administration of Gd (C). Postoperative (45 months after surgery) MR images (D–F) showing the size of the residual tumor is unchanged.

  • View in gallery

    Case 3. Photomicrographs obtained during pathological examination of tumor tissue. An H & E–stained section (A) showing the coexistence of ganglion cells (arrow) and glial cells. Results of immunohistochemistry testing for neurofilaments (B) and GFAP (C) revealing the glial cells classified as astrocytomas (WHO Grade II). Original magnification ·200 (B) and ·400 (A and C).


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