Limits...
A patient with multiple synchronous gliomas of distinctly different grades and correlative radiographic findings.

Nakhl F, Chang EM, Shiau JS, Alastra A, Wrzolek M, Odaimi M, Raden M, Juliano JE - Surg Neurol Int (2010)

Bottom Line: Magnetic resonance imaging (MRI) with and without gadolinium revealed a nonenhancing left temporal lobe mass without surrounding edema, an enhancing left frontal lobe mass with surrounding edema, and an enhancing right parietal lobe mass with surrounding edema.Intraoperative Brainlab® image-guided navigation was used.Postoperative treatment consisted of radiotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Hematology/Oncology, Staten Island University Hospital, Neuroscience Associates of New York, New York.

ABSTRACT

Background: Multiple gliomas represent approximately 2 to 5% of all high-grade gliomas which are categorized as multifocal or multicentric depending on the timing, location and pattern of spread. We present a patient with bi-hemispheric, noncontiguous, low- and high-grade gliomas proven by biopsy. She underwent surgical excision and radiotherapy, but unfortunately succumbed to her disease shortly thereafter.

Case description: A 64-year-old female presented to the hospital with confusion, disorientation and retrograde amnesia after an unwitnessed fall. There were no symptoms of headaches or visual disturbances before presentation. Magnetic resonance imaging (MRI) with and without gadolinium revealed a nonenhancing left temporal lobe mass without surrounding edema, an enhancing left frontal lobe mass with surrounding edema, and an enhancing right parietal lobe mass with surrounding edema. The patient underwent a left frontal craniotomy with gross total resection of the left frontal mass and a left temporal craniotomy, anterior temporal lobectomy and sub-total resection of the temporal lobe mass. Intraoperative BrainlabĀ® image-guided navigation was used. Postoperative treatment consisted of radiotherapy.

Conclusion: This is the first reported case of multiple separate glial tumors, each with differing grades in which an MRI can be correlated with the tissue diagnoses. This case also highlights the possible mechanisms of transformation of glial tumors in the continuum from benign to malignant forms, lending insight to the possibility of using advanced genetic analysis in the treatment and diagnosis of these entities.

No MeSH data available.


Related in: MedlinePlus

T2-weighted MR images without gadolinium. Left temporal lobe tumor with hyperintense signal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2958331&req=5

Figure 0005: T2-weighted MR images without gadolinium. Left temporal lobe tumor with hyperintense signal

Mentions: MRI of the brain with and without gadolinium was performed. Three lesions were detected. A left temporal lobe lesion was identified and was slightly hypo-intense on T1-weighted imaging and hyper-intense on T2-weighted imaging with no associated gadolinium enhancement or surrounding edema [Figure 1a; 2a,b]. The left frontal lobe lesion was predominantly hypo-intense on T1 and hyper-intense on T2-weighted images. It enhanced in an irregular ring-like fashion with surrounding edema [Figure 1b]. In the right parietal lobe there was an enhancing lesion predominantly hypo-intense on T1 and hyper-intense on T2-weighted images [Figure 1c]. A metastatic work-up consisting of bone scan and CT scans of the chest, abdomen and pelvis were negative.


A patient with multiple synchronous gliomas of distinctly different grades and correlative radiographic findings.

Nakhl F, Chang EM, Shiau JS, Alastra A, Wrzolek M, Odaimi M, Raden M, Juliano JE - Surg Neurol Int (2010)

T2-weighted MR images without gadolinium. Left temporal lobe tumor with hyperintense signal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2958331&req=5

Figure 0005: T2-weighted MR images without gadolinium. Left temporal lobe tumor with hyperintense signal
Mentions: MRI of the brain with and without gadolinium was performed. Three lesions were detected. A left temporal lobe lesion was identified and was slightly hypo-intense on T1-weighted imaging and hyper-intense on T2-weighted imaging with no associated gadolinium enhancement or surrounding edema [Figure 1a; 2a,b]. The left frontal lobe lesion was predominantly hypo-intense on T1 and hyper-intense on T2-weighted images. It enhanced in an irregular ring-like fashion with surrounding edema [Figure 1b]. In the right parietal lobe there was an enhancing lesion predominantly hypo-intense on T1 and hyper-intense on T2-weighted images [Figure 1c]. A metastatic work-up consisting of bone scan and CT scans of the chest, abdomen and pelvis were negative.

Bottom Line: Magnetic resonance imaging (MRI) with and without gadolinium revealed a nonenhancing left temporal lobe mass without surrounding edema, an enhancing left frontal lobe mass with surrounding edema, and an enhancing right parietal lobe mass with surrounding edema.Intraoperative Brainlab® image-guided navigation was used.Postoperative treatment consisted of radiotherapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Hematology/Oncology, Staten Island University Hospital, Neuroscience Associates of New York, New York.

ABSTRACT

Background: Multiple gliomas represent approximately 2 to 5% of all high-grade gliomas which are categorized as multifocal or multicentric depending on the timing, location and pattern of spread. We present a patient with bi-hemispheric, noncontiguous, low- and high-grade gliomas proven by biopsy. She underwent surgical excision and radiotherapy, but unfortunately succumbed to her disease shortly thereafter.

Case description: A 64-year-old female presented to the hospital with confusion, disorientation and retrograde amnesia after an unwitnessed fall. There were no symptoms of headaches or visual disturbances before presentation. Magnetic resonance imaging (MRI) with and without gadolinium revealed a nonenhancing left temporal lobe mass without surrounding edema, an enhancing left frontal lobe mass with surrounding edema, and an enhancing right parietal lobe mass with surrounding edema. The patient underwent a left frontal craniotomy with gross total resection of the left frontal mass and a left temporal craniotomy, anterior temporal lobectomy and sub-total resection of the temporal lobe mass. Intraoperative BrainlabĀ® image-guided navigation was used. Postoperative treatment consisted of radiotherapy.

Conclusion: This is the first reported case of multiple separate glial tumors, each with differing grades in which an MRI can be correlated with the tissue diagnoses. This case also highlights the possible mechanisms of transformation of glial tumors in the continuum from benign to malignant forms, lending insight to the possibility of using advanced genetic analysis in the treatment and diagnosis of these entities.

No MeSH data available.


Related in: MedlinePlus