Malignant transformation and leptomeningeal spread of recurrent ganglioglioma: case report and review of literature

Gangliogliomas are rare, typically benign low grade tumors which usually occur in the supratentorial compartment, more commonly in the pediatric age group. Malignant transformation of a low grade ganglioglioma in the absence of prior radiation therapy is exceptionally rare with only 17 such cases previously reported. The author present an additional case of malignant transformation of recurrent ganglioglioma. Unlike the prior cases however, the recurrent tumor in our case showed prominent intratumoral hemorrhage and widespread leptomeningeal spread. The rapidly fatal course in our case was likely secondary to tumor dedifferentiation which is supported by serial histopathological specimens.