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A rare case of multicentric synchronous bi-frontal glioma in a young female. Diagnostic and therapeutic problems: a case report.

Turola MC, Schivalocchi R, Ramponi V, De Vito A, Nanni MG, Frivoli GF - Cases J (2009)

Bottom Line: A month later, she presented apathy, apraxia, psychomotor slowdown and expressive aphasia.A Magnetic Resonance Imaging examination showed a bi-frontal lesion.Despite the absence of focal neurological signs and basal CT scan and EEG alterations, complementary imaging examinations, such as MRI and contrast enhancement CT, are necessary, especially when the conditions become quickly worse.

View Article: PubMed Central - HTML - PubMed

Affiliation: Servizio Psichiatrico Diagnosi e Cura AUSL Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. m.turola@ausl.fe.it.

ABSTRACT
Multicentric glioblastoma is a uncommon brain malignant tumour.We report the case of a 43-years-old woman, born in Ukraine and living in Italy, who manifested an initial isolated epileptic seizure and subsequent atypical psychiatric symptoms. Clinical neurological examination, Brain Computed Tomography and standard EEG examinations were negative at the moment of admission. A month later, she presented apathy, apraxia, psychomotor slowdown and expressive aphasia. A Magnetic Resonance Imaging examination showed a bi-frontal lesion. The patient underwent to two neurosurgical removals of the lesions: histological examination demonstrated the presence of a grade IV glioblastoma.Clinical onset, diagnostic and therapeutic problems are discussed.In case of atypical psychiatric presentation, it should be taken into consideration neoplastic, inflammatory or infective causes. Despite the absence of focal neurological signs and basal CT scan and EEG alterations, complementary imaging examinations, such as MRI and contrast enhancement CT, are necessary, especially when the conditions become quickly worse.

No MeSH data available.


Related in: MedlinePlus

A – Preoperative T1gado-axial Magnetic Resonance Imaging; B – Preoperative FLAIR-coronal Magnetic Resonance Imaging.
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Figure 3: A – Preoperative T1gado-axial Magnetic Resonance Imaging; B – Preoperative FLAIR-coronal Magnetic Resonance Imaging.

Mentions: A magnetic resonance imaging (MRI) showed two frontal focal lesions (4 × 3 cm on the left side and 5 × 4 cm on the right side) with peripheral contrast enhancement, surrounded by T1-ipointense and T2-hyperintense signal limited to frontal lobes (fig. Fig. 3). Functional sequences detected increased microvascular permeability and cerebral blood volume, suggesting neoangiogenesis.


A rare case of multicentric synchronous bi-frontal glioma in a young female. Diagnostic and therapeutic problems: a case report.

Turola MC, Schivalocchi R, Ramponi V, De Vito A, Nanni MG, Frivoli GF - Cases J (2009)

A – Preoperative T1gado-axial Magnetic Resonance Imaging; B – Preoperative FLAIR-coronal Magnetic Resonance Imaging.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651857&req=5

Figure 3: A – Preoperative T1gado-axial Magnetic Resonance Imaging; B – Preoperative FLAIR-coronal Magnetic Resonance Imaging.
Mentions: A magnetic resonance imaging (MRI) showed two frontal focal lesions (4 × 3 cm on the left side and 5 × 4 cm on the right side) with peripheral contrast enhancement, surrounded by T1-ipointense and T2-hyperintense signal limited to frontal lobes (fig. Fig. 3). Functional sequences detected increased microvascular permeability and cerebral blood volume, suggesting neoangiogenesis.

Bottom Line: A month later, she presented apathy, apraxia, psychomotor slowdown and expressive aphasia.A Magnetic Resonance Imaging examination showed a bi-frontal lesion.Despite the absence of focal neurological signs and basal CT scan and EEG alterations, complementary imaging examinations, such as MRI and contrast enhancement CT, are necessary, especially when the conditions become quickly worse.

View Article: PubMed Central - HTML - PubMed

Affiliation: Servizio Psichiatrico Diagnosi e Cura AUSL Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. m.turola@ausl.fe.it.

ABSTRACT
Multicentric glioblastoma is a uncommon brain malignant tumour.We report the case of a 43-years-old woman, born in Ukraine and living in Italy, who manifested an initial isolated epileptic seizure and subsequent atypical psychiatric symptoms. Clinical neurological examination, Brain Computed Tomography and standard EEG examinations were negative at the moment of admission. A month later, she presented apathy, apraxia, psychomotor slowdown and expressive aphasia. A Magnetic Resonance Imaging examination showed a bi-frontal lesion. The patient underwent to two neurosurgical removals of the lesions: histological examination demonstrated the presence of a grade IV glioblastoma.Clinical onset, diagnostic and therapeutic problems are discussed.In case of atypical psychiatric presentation, it should be taken into consideration neoplastic, inflammatory or infective causes. Despite the absence of focal neurological signs and basal CT scan and EEG alterations, complementary imaging examinations, such as MRI and contrast enhancement CT, are necessary, especially when the conditions become quickly worse.

No MeSH data available.


Related in: MedlinePlus