A Clinicoradiological Series of 39 Gangliogliomas - Insights into Surgical Outcomes and Prognostic Factors

Q: What was the study design and how many patients were included?

The study retrospectively reviewed 39 patients with histologically confirmed gangliogliomas. Clinical, imaging, surgical, and follow-up data were analyzed.

Q: Which clinical presentation and tumor locations were most common?

Epilepsy was the most common presenting symptom (94.9%). Tumors were predominantly temporal, followed by cerebellar and parietal locations.

Q: How did gross total resection relate to seizure outcomes and prognosis?

Gross total resection was achieved in 71.8% of cases and was significantly associated with seizure freedom (Engel Class I). Overall prognosis for classic low-grade tumors was excellent, with 100% 10-year survival for low-grade tumors.

Sep 30, 2026

Uploaded by hdkawk

A single-center retrospective analysis evaluates presentation, imaging, surgical management, and long-term outcomes in 39 histologically confirmed ganglioglioma patients. The cohort shows epilepsy as the dominant presenting feature, with temporal lobe tumors and solid-cystic morphology most frequently observed. Gross total resection is achieved in most cases and is strongly associated with seizure freedom at a mean 7.2-year follow-up. Recurrence or progression is linked to anaplastic histology and subtotal resection, while classic low-grade tumors demonstrate excellent long-term survival.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Background and Objectives

Methods

Results

Conclusion

Key Words

CLINICAL RESEARCH A Clinicoradiological Series of 39 Gangliogliomas: Insights into Surgical Outcomes and Prognostic Factors Moustafa A. Mansour, MBBCh, MSc, MPhil 1, Amr K. Elsamman, MD, PhD, FACS2 1Department of Neurosurgery, Nasser Institute for Research and Treatment, Cairo, Egypt; 2Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt Correspondence: Moustafa A. Mansour, MBBCh, MSc, MPhil, Department of Neurosurgery, Nasser Institute for Research and Treatment, 1351 Nile Corniche, As Sahel, El Sahel, Cairo Governorate 4350210, [Egypt. Email:](Egypt. Email: Moustafa.Medavatar@gmail.com)[ Moustafa.Medavatar@gmail.com](Egypt. Email: Moustafa.Medavatar@gmail.com) Received, September 05, 2025; Accepted, October 30, 2025; Published Online, January 8, 2026. Neurosurgery Practice 2026;7(1):e000194. [https://doi.org/10.1227/neuprac.0000000000000194](https://doi.org/10.1227/neuprac.0000000000000194) © The Author(s) 2026. Published by Wolters Kluwer Health, Inc. on behalf of Congress of Neurological Surgeons. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. BACKGROUND AND OBJECTIVES: Gangliogliomas (GGs) are rare, well-differentiated glioneuronal tumors, representing a common cause of neoplastic epilepsy. This study analyzes the presentation, management, and outcomes of a large single-center cohort. METHODS: We retrospectively reviewed 39 patients with histologically conﬁrmed GG. Data on demographics, clinical presentation, imaging, surgical management, and follow-up were analyzed. RESULTS: The mean patient age was 20.8 years. The most common presenting symptom was epilepsy (94.9%, 37/39), with complex partial seizures being predominant. Tumors were predominantly temporal (46.2%, 18/39), followed by cerebellar (15.4%, 6/39) and parietal (12.8%, 5/39) locations. A solid-cystic morphology was the most common radiological pattern (51.3%, 20/39). Gross total resection (GTR) was achieved in 71.8%(28/39) of cases. At a mean follow-up of 7.2 years, 86.5%(32/37) of patients with preoperative epilepsy were seizure-free (Engel Class I) . Seizure freedom was signiﬁcantly associated with GTR (P < .001) . Recurrence/progression was observed in 7 patients (17.9%), strongly associated with anaplastic histology (P < .001), and subtotal resection (P = .003) . The overall prognosis was excellent for classic GG, with a 100% 10-year survival rate for low-grade tumors. CONCLUSION: GGs have a favorable prognosis after GTR, with excellent rates of seizure control. Tumor recurrence, though rare, is linked to high-grade features and incomplete resection. This series underscores the importance of maximal safe resection as the primary treatment. KEY WORDS: Ganglioglioma, Epilepsy surgery, Seizure outcome, Gross total resection, Anaplastic, Brain tumor G angliogliomas (GGs) are rare, slow-growing neuroepithelial tumors that account for approximately 0.5% - 5% of all primary central nervous system tumors and represent a leading cause of neoplastic epilepsy in children and young adults.1,2 Histopathologically, these tumors are distinguished by their mixed composition of dysplastic neuronal elements and neoplastic glial components, predominantly astrocytic, which imparts both epileptogenic potential and proclivity for indolent growth.2,3 The temporal lobe is the most commonly affected site, and epilepsy, often drug-resistant, dominates the clinical presentation.3 While prior studies have broadly characterized GGs as World Health Organization (WHO) grade I or II tumors with generally favorable outcomes, rarer anaplastic GGs (AGGs, WHO grade III) are recognized as high grade, malignant tumors posing signiﬁcant challenges becaus

FAQs

What was the study design and how many patients were included?

The study retrospectively reviewed 39 patients with histologically confirmed gangliogliomas. Clinical, imaging, surgical, and follow-up data were analyzed.

Which clinical presentation and tumor locations were most common?

Epilepsy was the most common presenting symptom (94.9%). Tumors were predominantly temporal, followed by cerebellar and parietal locations.

How did gross total resection relate to seizure outcomes and prognosis?

Gross total resection was achieved in 71.8% of cases and was significantly associated with seizure freedom (Engel Class I). Overall prognosis for classic low-grade tumors was excellent, with 100% 10-year survival for low-grade tumors.

Sep 30, 2026

Uploaded by hdkawk