Figure 4a. Ganglioglioma in an 8-year-old girl with diplopia and headaches. (a) Axial CT image shows a large, heterogeneous mass of the posterior right temporal lobe. Calcification within the mass and thinning of the adjacent skull are clearly evident. (b) Axial T1-weighted MR image shows mild, heterogeneous low signal intensity of the mass. (c) Axial T2-weighted MR image shows a markedly heterogeneous appearance with apparent septa within the mass, which is hyperintense relative to the gray matter. (d) Contrast-enhanced coronal T1-weighted MR image shows intense enhancement in some areas and ringlike enhancement in others. (e) Intraoperative photograph obtained after opening of the dura shows an obviously bulging cortical surface. The mass was well-encapsulated, facilitating gross total resection. Histologic examination revealed a mixture of abnormal ganglion cells and astrocytes, with the astrocytic component appearing similar to pilocytic astrocytoma and oligodendroglioma.