Gangliogliomas are rare, usually low-grade CNS tumors (WHO grade I). A minority of tumors show more aggressive histopathologic features, these are called anaplastic gangliogliomas (WHO grade III). Gangliogliomas are most frequently found in the temporal lobes (70%), but can occur anywhere in the central nervous system. These tumors consist of two types of cells: ganglion cells and neoplastic glial element. 

Epilepsy is a common clinical presentation as this tumor has a typical occurrence in the temporal lobes.Their appearance on imaging is very variable: from a partially cystic mass with an enhancing mural nodule (~45% of cases) to a solid mass expanding the overlying gyrus. 

Epidemiology

The tumor is found mostly in children and young patients, no gender predilection is found. Gangliogliomas account for around 2% (from 0.4-3.8%) of all primary intracranial tumours, and up to 10% of primary cerebral tumours in children.

MRI features

T1:  The solid component is iso- to hypointense

T1 C+ (Gd): Usually a solid component with variable contrast enhancement

T2: T2 shows a hyperintense solid component and a variable signal in the cystic component depending on the amount of proteinaceous material or presence of blood products. Peri-tumoral FLAIR/T2 oedema is distinctly uncommon.