Gliomatosis cerebri

Case contributed by Dr Ahmed Abd Rabou

Presentation

Headache, diplopia, nausea and right upper and lower limb weakness.

Patient Data

Age: 40 years old
Gender: Male

MRI Brain

Modality: MRI

An ill defined diffuse infiltrative process involving the deep white matter of left cerebral hemisphere mainly the temporal, frontal and parietal lobes, internal and external capsules, thalamus, left cerebral peduncle and left hemipons and contralaterally it extends through the corpus callosum to the right forceps minor fibers. The lesion displays bright signal on T2 and FLAIR, iso intense signal on T1 with no significant contrast enhancement or diffusion restriction. Mass effect in form of subfalcine herniation causing right lateral ventricular dilatation and transependymal CSF leakage are noted as well.

Case Discussion

The clinical presentation and MRI findings are suggestive of Gliomatosis cerebri which carries a poor prognostic outcome. Pathology reveals WHO grade III lesion.

 

Importantly, whereas gliomatosis was previously considered a distinct entity, since the 2016 update to the WHO classification of CNS tumours it is now merely thought of as a growth pattern.

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Case Information

rID: 40197
Case created: 11th Oct 2015
Last edited: 21st Jul 2016
Inclusion in quiz mode: Included

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