Unusual Locations of Gangliogliomas: Intraventricular and Posterior Fossa

To report a series of patients diagnosed with gangliogliomas (GG) in unusual locations; and to review the clinical and imaging features as well as surgical treatment and outcomes.

A series of consecutive patients who underwent surgery for GGs at unusual locations, such as intraventricular region and posterior fossa, from 2010 to 2022 were included in the study.

Nine patients with GGs located in unusual areas, one in the intraventricular region and 8 in the posterior fossa, were included. There were 5 males and 4 females, with a mean age 31±8.5 years. We performed GTR in 6 cases and STR in 3 cases. Seven tumors were grade I WHO while the remaining two were anaplastic. Five patients also had preoperative hydrocephalus. We found a positive correlation between midline GG of the posterior fossa and solid aspect of the tumor (p=0.05). Univariate analysis found no other statistically significant associations, but this was due to the small patient sample. Recurrence was seen in 2 cases with STR, after 1 and 10 years, respectively.

GG should be considered in the differential diagnosis of patients with tumors in the intraventricular region or posterior fossa. Maximal tumor resection and restoration of CSF flow pathways ensure a good outcome. Growth patterns correlate with resection and can help choose the best candidates for surgery. However, further studies on large patient samples are needed.