Chen Yi-Ren, Kim Lily H, Born Donald E, Chen Doris P, Edwards Michael S
Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California.
Department of Pathology, Stanford University Medical Center, Palo Alto, California.
J Neurosurg Case Lessons. 2025 Mar 10;9(10). doi: 10.3171/CASE24442.
Gangliogliomas are low-grade gliomas typically found in the temporal lobes with a low rate of malignant transformation. In rare cases, they may be found in the spinal axis.
An 8-year-old boy presented with 2 months of neck pain and upper extremity incoordination and was found to have a cervicomedullary lesion. An occipital craniectomy and a C1 laminectomy with C2-5 laminoplasty were performed for biopsy and partial resection. The pathological diagnosis was consistent with ganglioglioma, and the patient was followed with serial MRI. He presented 1.5 years later with urinary incontinence and a precipitous decline in upper extremity strength. MRI showed expansion of the cervicomedullary junction with new ring enhancement. A repeat biopsy was performed, showing glioblastoma. The patient underwent daily radiotherapy, with improvement in his upper extremity weakness. Subsequently, the patient was started on chemotherapy and required placement of an external drain followed by a programmable ventriculoperitoneal shunt prior to his unfortunate death.
In this case, the ganglioglioma arose in the cervical spine, with malignant transformation to glioblastoma 1.5 years after diagnosis. In children with a history of spinal ganglioglioma presenting with bowel/bladder dysfunction and worsening strength, a differential diagnosis of malignant progression should be kept in mind. https://thejns.org/doi/10.3171/CASE24442.
节细胞胶质瘤是一种低级别胶质瘤，通常发生于颞叶，恶性转化发生率较低。在罕见情况下，它们也可能出现在脊柱。
一名8岁男孩因颈部疼痛和上肢运动不协调2个月就诊，检查发现有颈髓病变。行枕下颅骨切除术、C1椎板切除术及C2-5椎板成形术以进行活检和部分切除。病理诊断为节细胞胶质瘤，随后对该患者进行了系列磁共振成像（MRI）随访。1.5年后，他出现尿失禁，上肢力量急剧下降。MRI显示颈髓交界处扩大，有新的环形强化。再次活检显示为胶质母细胞瘤。患者接受了每日放疗，上肢无力症状有所改善。随后，患者开始化疗，在不幸去世前，需要放置外置引流管，随后又置入了可编程脑室腹腔分流管。
在本病例中，节细胞胶质瘤起源于颈椎，诊断1.5年后发生恶性转化为胶质母细胞瘤。对于有脊髓节细胞胶质瘤病史且出现肠道/膀胱功能障碍和肌力恶化的儿童，应考虑恶性进展的鉴别诊断。https://thejns.org/doi/10.3171/CASE24442 。
