PMC8571360_01
Serial magnetic resonance imaging (MRI) images of the ganglioglioma. Sagittal T2 weighted MRI (a), Sagittal T1 weighted MRI (b), diffusion-weighted imaging (c), Sagittal T1 weighted MRI (d), Sagittal T1 weighted MRI from October 2019 showing a reduction in tumor size (e), and a Sagittal T1 weighted MRI from March 2021 showing a stable tumor appearance (f).
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F1
Subsequent magnetic resonance imaging (MRI) demonstrated a lobulated mass within the third ventricle which demonstrated mildly increased signal on T2 weighted imaging [Figure 1a], isodensity on T1 weighted imaging [Figure 1b], and no restricted diffusion [Figure 1c]. There was increased mass effect on the midbrain and tectal plate due to the increased size of the dorsal cystic component of the tumor (from 11 x 4 x 8 mm to 24 x 12 x 14 mm) [Figure 1d]. October 2019 demonstrated a significant reduction in tumor size from 22 x 12 mm to 17 x 8 mm [Figure 1e]. One month later she developed painful feet secondary to pitted keratolysis, likely secondary to dabrafenib. Three MRI scans performed in August 2020, February, March, and June of 2021 all demonstrated a stable tumor appearance [Figure 1f].
Hematoxylin and eosin image of ganglioglioma from the illustrative case in low (a) and high power (b) magnification.
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F2
Histology was consistent with a WHO grade I GG [Figure 2a and b]. There is also a neoplastic glial component with no necrosis seen [Figure 2a and b].