Multifocal Intracranial Ganglioglioma in a Sexagenarian: A Case Report and Review of the Current Literature

Abstract Background Gangliogliomas are rare, well differentiated, low grade neoplasms that most commonly occur unifocally in children, and most commonly affect the temporal lobe. Gangliogliomas that occur in patients over 40 tend to have worse prognoses. These tumors generally stain positively for neural and glial cell markers, as well as CD34. The purpose of this study was both to report an unprecedented case of multifocal intracranial ganglioglioma in an adult over 40 who had a favorable course, as well as to review the current literature surrounding multifocal intracranial gangliogliomas. Case Description A 60-year-old female presented to her ophthalmologist with blurry vision in the right eye and unremarkable neurological exam. She was referred for brain imaging, which showed multiple lesions in both cerebral hemispheres. Biopsy of the right occipital lesion was elected, as it enhanced most on MRI. Conclusion Multifocal intracranial gangliogliomas are exceedingly rare tumors, especially in adults. These tumors present unique management barriers, as they are multifocal at the time of diagnosis, making resection more technically challenging. In our review, the average age at diagnosis was 19.2, and 80% of the cases had at least one lesion in the temporal lobe. Two studies opted for resection of intracranial tumors, whereas the remaining studies performed biopsy with conservative management and serial imaging. Biopsy was performed in all cases. We present the first case of an intracranial multifocal ganglioglioma in a patient over 40 with lesions in the occipital lobe, corpus callosum and frontal lobe at presentation.