Brainstem gangliogliomas: a retrospective series

Clinical article

Si ZhangDepartment of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China

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Xiang WangDepartment of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China

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Xuesong LiuDepartment of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China

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Yan JuDepartment of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China

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Xuhui HuiDepartment of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China

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Object

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.

Methods

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.

Results

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.

Conclusions

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.
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