Treatment and Outcomes for Gangliogliomas: A Single-Center Review of 16 Patients

BACKGROUND: Ganglioglioma is a rare and slowly growing benign tumor. We investigated the outcomes of patients who underwent different combination treatments. METHODS: Between 1998 and 2012, 16 patients, including 11 men and 5 women, with a median age of 12.5 years (range, 2.5-65 years) were treated for intracranial gangliogliomas at our institution. The median follow-up period was 5.7 years (range, 48 days-15.6 years). Fifteen cases were included in the outcome assessment because one patient was lost to follow-up. Complete resection was achieved in 8 (53%) patients. Six (40%) patients underwent incomplete resection with or without adjuvant radiotherapy, and one patient with a brainstem tumor underwent only stereotactic biopsy. RESULTS: Gangliogliomas predominantly affected young (87.5%), male patients and most frequently presented with seizures (64%). Of eight patients who underwent complete resection, seven did not show recurrence, whereas only three of six with incomplete resection showed no recurrence. Four patients with recurrence received salvage treatments (two repeat surgeries and two radiosurgeries). A tumor control rate of 93% (14/15) was achieved at the last follow-up. No recurrence or malignant changes were observed after a median follow-up of 12 and 4.5 years in four patients who received gamma knife (GK) radiosurgery as adjuvant and salvage treatment. CONCLUSION: Complete resection produced the best outcomes and incomplete resection followed by adjuvant or salvage treatments showed favorable outcomes. In patients who are not eligible for complete resection because of tumor location or potential neurologic deficits following surgery, GK radiosurgery should be considered for the treatment of residual or recurrent tumors.

Ossified Ligamentum Flavum causing Cervical Myelopathy

Ossification of the ligamentum flavum (OLF) causing compressive cervical myelopathy or radiculopathy is rare. A 50-year-old male was admitted for progressive hypesthesia and paresthesia of both hands and a gradually worsening gait. MRI and CT scans demonstrated ossification of the left ligamentum flavum with dural sac and cord compression at the C5-6 level. The ossified ligamentum flavum was removed through a subtotal laminectomy and left side foraminotomy of the C5-6. Postoperatively, his gait improved remarkably and the sensory symptoms gradually resolved.