The authors present a pediatric case of
ganglioglioma occurring in the medulla oblongata. A 7-year-old boy was referred to our hospital with complaints of
ataxia, seizure and
sleep apnea. MRI of the brain disclosed a large
tumor occupying the medulla oblongata, and the upper portion of the cervical spinal cord was also involved. The patient underwent midline suboccipital
craniotomy and
laminectomy of C1 to attempt radical resection of the
tumor, which resulted only in partial removal of the
tumor due to severe
bradycardia during the operation. The histological diagnosis was
ganglioglioma, WHO grade 2. Although both
radiotherapy and
chemotherapy were performed following the operation, the
tumor remained unchanged. The patient died of respiratory arrest five months after the operation.
Gangliogliomas usually occur in the supratentorial region, which permits easy surgical access and good prognosis. Only 3% of
gangliogliomas occur in the brain stem, and its management can be challenging because of the difficulty of radical resection and poor response to both
radiotherapy and
chemotherapy.