Board Review 2 – Case 8

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This patient is a young patient with seizures. Imaging shows a small and somewhat cystic mass in the right temporal lobe. There is minimal surrounding FLAIR abnormality, with minimal enhancement on post-contrast imaging.

There is a differential for low grade appearing masses in the temporal lobe which includes ganglioglioma, dysembryoplastic neuroepithelial tumor (DNET), and pleomorphic xanthoastrocytoma (PXA). You will not always be able to tell the difference. Gangliogliomas are said to be more likely to enhance than DNET, but this is frequently not the case (as in this case).

The diagnosis is: ganglioglioma.

Ganglioglioma is the most common neoplastic cause of seizures, and are commonly found in younger patients and in the temporal lobes.