Butterfly glioma
Dr Sajoscha Sorrentino and Dr Frank Gaillard et al.
A butterfly glioma refers to a high grade astrocytoma, usually a GBM (WHO grade IV), which crosses the midline via the corpus callosum. Other white matter commissures are also occasionally involved. The term butterfly refers to the symmetric wing like extensions across the midline.
Most frequently butterfly gliomas occur in the frontal lobes, crossing via the genu of the corpus callosum, however posterior butterflies are also encountered.
Like all high grade gliomas the prognosis is dismal, and usually no attempt at 'curative' resection is made.
Differential diagnosis
- primary CNS lymphoma : especially in AIDS patients
- cerebral toxoplasmosis : especially in AIDS patients
- tumefactive demyelination
- cerebral metastases (rare)
- occasionally a leptomeningeal process which fills the quadrigeminal and ambient cisterns can cause confusion
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