Korean J Leg Med.  2015 Aug;39(3):78-83. 10.7580/kjlm.2015.39.3.78.

Undiagnosed Anaplastic Ganglioglioma Resulting in the Sudden Unexpected Death of a Young Woman

• Kim MY
• Kim H
• Park SH
• Lee SD

• KMID: 2044953
• DOI: http://doi.org/10.7580/kjlm.2015.39.3.78

Abstract

Intracranial neoplasms usually have definitive symptoms, causing a need for medical intervention, but a few cases result in sudden unexpected death even before diagnosis. In these cases, autopsy or post-mortem imaging may be the only way of identifying the existence of a tumor, so investigators or forensic specialists who participate in the post-mortem inspection should be aware of these possibilities. We report on a case of a 26-year-old woman without any medical history found dead in her home. A 5-cm intraventricular tumor was found during autopsy, which was histologically consistent with anaplastic ganglioglioma a very rare type of neuroglial tumor with the potential for malignant behavior. The tumor showed the characteristic features of anaplastic ganglioglioma, such as increased cellularity, a high Ki-67 proliferative index, and necrosis. There were signs of increased intracranial pressure, including flattened gyri and dilated ventricles, which led to the conclusion that this brain tumor was the cause of death.

Keyword

Unknown primary neoplasms; Brain neoplasms; Ganglioglioma; Cause of death

MeSH Terms

Adult
Autopsy
Brain Neoplasms
Cause of Death
Diagnosis
Female
Ganglioglioma*
Humans
Intracranial Pressure
Necrosis
Neoplasms, Unknown Primary
Research Personnel
Specialization

Figure

• 

  Fig. 1. (A) Flattened gyri of the cerebral cortex are observed, implying increased intracranial pressure. (B) The tumor was located in the right lateral and third ventricle, resulting in ventricular dilation. The cut surface of the tumor shows focal hemorrhage and necrosis.

• 

  Fig. 2. (A) Microscopic image showing the tumor border with a relatively distinct demarcation but without encapsulation. (B) Large multinucleated ganglion cells can be seen admixed with glial cells in the neutrophilic background. The ganglion cells show prominent nucleoli and abundant eosinophilic cytoplasm. Anaplastic changes can be observed, such as increased cellularity (C), a high Ki-67 proliferative index (D), and necrosis (E) in multifocal areas (A, H&E, 12.5; B, H&E, 200; C, H&E, 100; D, Ki-67, 100; E, H&E, 200).

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