Gangliogliomas are rare, slow-growing tumors that form in the central nervous system. These tumors have a unique makeup, consisting of both neuronal cells, which transmit information, and glial cells, which provide support and structure. Understanding their nature and how they are addressed is important.
What Are Gangliogliomas?
Gangliogliomas originate from two types of cells: neuronal (ganglion) cells and glial cells. They are classified as low-grade tumors by the World Health Organization (WHO), meaning they are generally not cancerous and do not typically spread.
These tumors are most frequently found in the temporal lobes of the brain. However, gangliogliomas can appear in various other parts of the central nervous system, including the cerebrum, cerebellum, brainstem, or spinal cord. Although most gangliogliomas are low-grade, in rare instances, the glial component can undergo changes, leading to a higher-grade, more aggressive form.
Identifying Symptoms and Diagnosis
The symptoms associated with gangliogliomas can differ depending on where the tumor is located within the brain or spinal cord. Seizures are a very common symptom, particularly when the tumor is in the temporal lobe, and can often be one of the first indicators. Other symptoms may include headaches, which can be worse in the morning, nausea, vomiting, fatigue, or weakness on one side of the body.
Diagnosis begins with a thorough medical history and a neurological examination. This examination assesses various aspects of brain function, such as reflexes, muscle strength, eye and mouth movement, coordination, and alertness. Imaging techniques, especially Magnetic Resonance Imaging (MRI) with contrast, are then used to visualize the tumor, helping to determine its size, location, and specific characteristics.
While imaging provides valuable information, a definitive diagnosis requires a biopsy. During this procedure, a small sample of the tumor tissue is removed and examined under a microscope by a pathologist. This microscopic analysis confirms the presence of both neuronal and glial cells, allowing for accurate classification of the tumor.
Treatment Options
The primary treatment for gangliogliomas is surgical removal, known as surgical resection. The goal of surgery is to remove as much of the tumor as safely possible, ideally achieving complete removal. For most low-grade gangliogliomas, complete surgical resection is often curative and significantly improves the long-term outlook.
If complete removal is not feasible due to the tumor’s location or concerns about potential neurological deficits, or if the tumor is a higher-grade type, additional treatments may be considered. These adjuvant therapies can include radiation therapy or chemotherapy. Radiation therapy might be used to target any remaining tumor cells, while chemotherapy may be employed in more aggressive or recurrent cases.
For low-grade gangliogliomas, radiation therapy is not needed if the tumor has been completely removed. However, if some tumor remains after surgery, or if there is a recurrence, radiation therapy may be beneficial in controlling tumor growth. The decision to use these additional therapies is made on an individual basis, considering the tumor’s characteristics and the patient’s overall health.
Outlook and Long-Term Care
The outlook for individuals diagnosed with gangliogliomas is favorable, especially when the tumor is low-grade and can be entirely removed through surgery. Studies indicate a high five-year survival rate, exceeding 90%, for children with gangliogliomas.
Ongoing follow-up care is an important aspect of managing gangliogliomas, even after successful treatment. Regular MRI scans are performed to monitor for any signs of tumor recurrence. These scans help detect any new growth early, allowing for timely intervention if needed.
Some individuals may require continued management of symptoms, such as seizures, even after the tumor has been removed. This might involve ongoing medication or other supportive therapies. Rehabilitation services may also be beneficial for addressing any neurological deficits that might persist after treatment, helping individuals regain function and improve their quality of life.