Skip to main content
Log in

High amino acid uptake in a low-grade desmoplastic infantile ganglioglioma in a 14-year-old patient

  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

Amino acid uptake is higher in high-grade than in low-grade gliomas; this is the rationale for using radioactively labelled amino acids for the non-invasive grading of brain neoplasms. We present a 14-year-old boy with a low-grade desmoplastic infantile ganglioglioma (DIG) that exhibited marked contrast enhancement on magnetic resonance imaging (MRI), but no signs of infiltration and only minimal surrounding edema. In this benign neoplasm the relative uptake of the radioactively labelled amino acid I-123-α-methyl tyrosine (IMT), determined using single-photon emission computed tomography (SPECT), was 3.24; it was considerably higher than that of eleven other pretherapeutic low-grade gliomas where it ranged from 1.06 to 1.94 and also markedly above the average value of 2.37 found in 20 high-grade gliomas. This case report illustrates that results from emission tomography with radioactively labelled amino acids must be interpreted with caution, particularly when rare tumor entities are considered in view of uncommon clinical or radiological findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chang LT A method of for attenuation correction in radionuclide computed tomography. IEEE Trans Nucl Sci NS-26/2 (1978) 2780

  2. Derlon JM, C Bourdet, P Bustany, M Chatel, J Theron, F Darcel, A Syrota: [11C]L-methionine uptake in gliomas. Neurosurgery 25 (1989) 720–728

    Google Scholar 

  3. Di Chiro G, E Oldfield, D Bairamian, NJ Patronas, RA Brooks, L Mansi, BH Smith, PL Kornblith, R Margolin: Metabolic imaging of the brain stem and spinal cord: studies with proton emission tomography using18F-2-deoxyglucose in normal and pathological cases. J Comput Assist Tomogr 7 (1983) 937–945

    Google Scholar 

  4. Di Chiro G: Positron emission tomography using [18F] Fluorodeoxyglucose in brain tumors: a powerful diagnostic and prognostic tool. Invest Radiol 22 (1986) 360–371

    Google Scholar 

  5. Glantz MJ, PC Burger, JE Herndon, AH Friedman, JG Cairncross, NA Vick, SC Schold: Influence of the type of surgery on the histologic diagnosis in patients with anaplastic gliomas. Neurology 41 (1991) 1741–1744

    Google Scholar 

  6. Herholz K: Tracers for clinical evaluation of gliomas: a neurologist's view. In:Mazoyer BM, et al. (eds): PET studies on amino acid metabolism and protein synthesis. Kluwer Academic Publishers, Netherlands 1993

    Google Scholar 

  7. Ishida Y, Tamura M: Desmoplastic ganglioglioma. Brain Tumor Pathol 8 (1991) 79–83

    Google Scholar 

  8. Isselbacher KJ: Increased uptake of amino acids and 2-deoxy-D-glucose by virus-transformed cells in culture. Proc Natl Acad Sci USA 69 (1972) 585–589

    Google Scholar 

  9. Kleihues, P, PC Burger, BW Scheithauer: The new WHO classification of brain tumors. Brain Pathol 3 (1993) 255–268

    Google Scholar 

  10. Kuchelmeister K, M Bergmann, K von Wild, D Hochreuther, G Busch, F Gullotta: Desmoplastic ganglioglioma: report of two non-infantile cases. Acta Neuropathol (Berl) 85 (1993) 199–204

    Google Scholar 

  11. Kuwert T, C Morgenroth, B Woesler, P Matheja, S Palkovic, B Vollet, M Schafers, H Wassmann, O Schober: Influence of size of regions of interest on the measurement of uptake of iodine-123-α-methyl tyrosine by brain tumors. Nucl Med Commun 17 (1996) 609–615

    Google Scholar 

  12. Kuwert T, C Morgenroth, B Woesler, P Matheja, S Palkovic, B Vollet, S Samnick, U Maasjosthusmann, H Lerch, FJ Gildehaus, H Wassmann, O Schober: Uptake of iodine-123-α-methyl tyrosine by primary brain tumors and non-neoplastic brain lesions. Ent J Nucl Med 23 (1996) 1345–1353

    Google Scholar 

  13. Ogawa T, F Shishido, I Kanno, A Inugami, H Fujita, M Murakami, E Shimosegawa, H Ito, J Hatazawa, T Okudera, K Uemura, N Yasui, K Mineura: Cerebral glioma: evaluation with methionine PET Radiology 186 (1993) 45–53

    Google Scholar 

  14. O'Tuama LA, B Bjornson, H Chugani, ST Treves: Brain. In:Treves ST (ed): Pediatric nuclear medicine. 2nd ed. Springer-Verlag, New York 1995

    Google Scholar 

  15. O'Tuama LA,PC Phillips, LC Strauss, BC Carson, Y Uno, QR Smith, RF Dannals, AA Wilson, HT Ravert, S Loats, HA Loats, ND Lafrance, HN Wagner: Two-phase [11C]L-methionine PET in childhood brain tumors. Pediatr Neurol 6 (1990) 163–170

    Google Scholar 

  16. O'Tuama LA, ST Treves, G Larar, AB Packard, AJ Kwan, PD Barnes, RM Scott, PM Black, JR Madsen, LC Goumnerova, SE Sallan, NJ Tarbell:201TI versus99mTc-MIBI SPECT in evaluation of childhood brain tumors: a within-subject comparison. J Nucl Med 34 (1993) 1045–1051

    Google Scholar 

  17. Perkins OC: Ganglioglioma. Arch Pathol Lab Med 2 (1926) 11–17

    Google Scholar 

  18. Schmidek HH: Surgical management of supratentorial gliomas. In:Schmidek, HH, WH Sweet (eds): Operative neurosurgical techniques. 3rd ed. WB Saunders Company, Philadelphia 1995

    Google Scholar 

  19. Schober O, GJ Meyer, C Duden, L Ladenstein, J Niggemann, JA Müller, MR Gaab, H Becker, H Dietz, H Hundeshagen: Amino acid uptake in brain tumors using positron emission tomography as an indicator for evaluating metabolic activity and malignancy. Fortschr Röntgenstr 147 (1987) 503–509

    Google Scholar 

  20. Tien RD, SL Tuori, N Pulkingham, PC Burger: Ganglioglioma with leptomeningeal and subarachnoid spread: results of CT, MR, and PET imaging. AJR 159 (1992) 391–393

    Google Scholar 

  21. Vandenberg SR, EE May, LJ Rubinstein, MM Herman, E Perentes, SA Vinores, VP Collins, TS Park: Desmoplastic supratentorial neuroepithelial tumors of infancy with divergent differentiation potential (“desmoplastic infantile gangliogliomas”). J Neurosurg 66 (1987) 58–71

    Google Scholar 

  22. Vandenberg SR: Desmoplastic infantile ganglioma and desmoplastic cerebral astrocytoma of infancy. Brain Pathol 3 (1993) 275–281

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Woesler, B., Kuwerte, T., Kurlemann, G. et al. High amino acid uptake in a low-grade desmoplastic infantile ganglioglioma in a 14-year-old patient. Neurosurg. Rev. 21, 31–35 (1998). https://doi.org/10.1007/BF01111482

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01111482

Keywords

Navigation