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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(06): s00451809659
DOI: 10.1055/s-0045-1809659
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Angiocentric glioma in refractory epilepsy: when to suspect?

Angelo Dante de Carvalho Corrêa 
1   Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.
,
Sérgio Ferreira Alves Júnior 
1   Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.
2   Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.
,
Luis Alcides Quevedo Canete 
1   Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.
,
Nina Ventura 
1   Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.
2   Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.
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A 9-year-old boy presented with partial seizures that had progressively worsened throughout the previous 4 months; the patient was refractory to oral medication. Magnetic resonance imaging (MRI) scans ([Figure 1]) were performed, which demonstrated an expansive right frontal lesion, suggesting a tumor from the group of long-term epilepsy associated tumors (LEATs), with some findings suggestive of angiocentric glioma (AG),[1] [2] confirmed after surgical resection.

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Figure 1 Non-contrast T1-weighted imaging (T1-WI) (A) showing an expansive right frontal lesion with faint areas of hyperintense signal in its periphery (white arrowheads), a feature commonly observed in angiocentric glioma (AG). Fluid-attenuated inversion recovery (FLAIR) (B) and T2-weighted imaging (T2-WI) (C) showing a band of hyperintense signal extending from the lesion to the right lateral ventricle (Stalk-like sign; white arrows), which may represent tumor growth along the vessels. These two findings, within the clinical context, favored the diagnosis of AG. Moreover, the lesion did not present contrast enhancement on postcontrast T1-WI (D), neither foci of restricted diffusion (E) nor foci of bleeding or calcification in the susceptibility-weighted imaging (SWI) (F), findings that are usually absent in AG.

A rare World Health Organization (WHO) grade 1. pediatric-type. diffuse low-grade glioma,[3] AG is an epileptogenic lesion often observed in young patients.[4] The imaging findings ([Figure 1]) may be characteristic and lead to radiological suspicion before surgery,[1] [2] which can be essential for correct patient management.


 

Conflict of Interest

The authors have no conflict of interest to declare.

Authors' Contributions

Conceptualization: ADCC, SFAJ, LAQC, NVW; Data curation: ADCC, SFAJ, LAQC; Investigation: ADCC, SFAJ, LAQC; Writing – original draft: ADCC, SFAJ, LAQC; Writing – review & editing: NVW.


Data Availability Statement

The data supporting the conclusions of this study are available on our institution's database.


Editor-in-Chief: Hélio A. G. Teive https://orcid.org/0000-0003-2305-1073.


Associate Editor: Leandro Tavares Lucato https://orcid.org/0000-0001-9181-5245.



Address for correspondence

Ângelo Dante Correa de Carvalho

Publikationsverlauf

Eingereicht: 21. Februar 2025

Angenommen: 08. März 2025

Artikel online veröffentlicht:
25. Juni 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Angelo Dante de Carvalho Corrêa, Sérgio Ferreira Alves Júnior, Luis Alcides Quevedo Canete, Nina Ventura. Angiocentric glioma in refractory epilepsy: when to suspect?. Arq Neuropsiquiatr 2025; 83: s00451809659.
DOI: 10.1055/s-0045-1809659

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Zoom
Figure 1 Non-contrast T1-weighted imaging (T1-WI) (A) showing an expansive right frontal lesion with faint areas of hyperintense signal in its periphery (white arrowheads), a feature commonly observed in angiocentric glioma (AG). Fluid-attenuated inversion recovery (FLAIR) (B) and T2-weighted imaging (T2-WI) (C) showing a band of hyperintense signal extending from the lesion to the right lateral ventricle (Stalk-like sign; white arrows), which may represent tumor growth along the vessels. These two findings, within the clinical context, favored the diagnosis of AG. Moreover, the lesion did not present contrast enhancement on postcontrast T1-WI (D), neither foci of restricted diffusion (E) nor foci of bleeding or calcification in the susceptibility-weighted imaging (SWI) (F), findings that are usually absent in AG.