Malignant glial tumor arising from the site of a previous hamartoma/ganglioglioma: Coincidence or malignant transformation?

That the originally resected gangliogliomascreening are generally considere d benign tumors. Although more commonly found in the brain, spinal cord gan glioglioma is a well established, albeit infrequent, entity. We describe a 2-decade clinical course of a patient initially diagnosed with a thoracolum bar 'glial-neuronal hamartoma' at age 4. Seventeen years after his first op eration, local recurrence was noted. Despite subsequent multiple gross tota l resections and adjuvant therapy, histologic features became increasingly ominous and ultimately proved fatal. This is an unusual report and histolog ic presentation of a resected spinal cord ganglioglioma recurring as an ana plastic ependymoma/astrocytoma and subsequently a glioblastoma. It was actu ally part of a primitive neuroectodermal tumor which had undergone extensiv e maturation.