Клинический случай анапластической ганглиоглиомы de novo и современное состояние проблемы

Abstract

The authors report a rare case of de novo malignant ganglioglioma (WHO grade III) in a 26-year old female. The patient has complained of periodic feeling fear, anxiety, episodes of impaired consciousness with extremity muscle cramps sometimes followed by urination, as well as flashes before eyes. Computed tomography perfusion and magnetic resonance spectroscopy were carried out for differential diagnosis between different types of tumors. Stereotactic biopsy was performed for histological examination. High surgical risk became a contraindication to gross total resection of the tumor. The patient has received radiation therapy (Trilogy linear accelerator) in a total dose of 60 Gy. The tumor shrank significantly. In 7 months, monitoring MRT did not detect further growth of the tumor. The authors have analyzed the case and reviewed the existing literature data regarding gangliogliomas. Taking into account low prevalence of these tumors (0.4-1% of all brain tumors), especially of their malignant forms (3-10% of gangliogliomas), lack of sufficient data regarding prognostic factors, life expectancy, time of recurrence, lack of accurate indications for different methods of treatment (surgery, radiation, chemotherapy), these tumors still need further research that should also involve supplementary neuroimaging techniques and stereotactic biopsy.