Gliomatosis cerebri: findings with computed tomography and magnetic resonance imaging

Ponce, Pedro; Alvarez-Santullano, M.Victoria; Otermin, Emilio; Santana, Miguel Angel; Ludeña, MaVicenta Garcı́a

doi:10.1016/s0720-048x(97)00172-1

Cited by 30 publications

(18 citation statements)

References 8 publications

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“…Clinical findings are usually indirect and nonspecific, though the occurrence of specific findings varies among different studies [5][6][7][10][11][12][13][14][15]. Subtle cognitive and emotional alterations occur before dementia that develops later in the course of GC.…”

Section: Discussionmentioning

confidence: 99%

Clinical presentation and surgical management of Glomatosis Cerebri

AlQazaz

Elsamahy

2018

International Journal of Scientific Research and Sustainable De

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Background: Glomatosis Cerebri (GC) is a diffuse brain neoplasm whose prognosis is unfavourable. Aim: to investigate the clinical presentation, radiological and pathological features, and outcomes after treatment of GC. Patients and Methods: We collected data from fifteen patients with GC treated at Suez Canal University, during a ten-year period. The diagnosis was based on magnetic resonance imaging (MRI) findings and tissue biopsy of all patients except one patient who received blind radiotherapy. Results: Seven patients were male (47%), and their median age at presentation was 43 years (range, 6 75 years). Statistical analysis demonstrated median survival as follows: blind radiotherapy, 1 month (n = 1); biopsy then radiotherapy, 19 months (8 32 months; n = 9); subtotal excision then radiotherapy, 5 months (1-7 months; n=5). Karnofsky Performance Scale scores of 70 and tumor grade were both significantly related to length of survival. Conclusion: Our findings suggest that biopsies are useful not only for diagnosis but also for prediction of the length of survival.

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Section: Discussionmentioning

confidence: 99%

Clinical presentation and surgical management of Glomatosis Cerebri

AlQazaz

Elsamahy

2018

International Journal of Scientific Research and Sustainable De

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“…However, there are no reports on a similar disease in dogs. In this study the areas affected by neoplastic infiltration did not express contrast enhancement suggesting bloodbrain integrity [36] as described for low-grade gliomas [26][27][28] and GC in humans [16,37] as in dogs [9,11,22,24].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Telencephalic Gliomatosis Cerebri in a Dog

Ricciardi¹,

Simone²,

Giannuzzi³

et al. 2014

Case Reports in Veterinary Medicine

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An 8-year-old intact male Lagotto Romagnolo was presented with forebrain signs. Neuroanatomic localization was diffuse prosencephalon. MRI revealed diffuse, bilateral, and symmetric T2 and FLAIR hyperintensities in the parieto-occipital white matter and corpus callosum. No mass effect or contrast enhancement was noted. Analysis of cerebrospinal fluid revealed normal protein content and mild mononuclear pleocytosis. Atypical cells were not identified. 15 days later because of the worsening of clinical condition the patient was euthanized upon owner's request. Neuropathological investigations were consistent with gliomatosis cerebri (GC). Such an unusual imaging pattern appeared similar to some cases of human GC and to a previous reported case in a dog, suggesting a possible repeatable imaging findings for this rare brain neoplasm. GC should be included in the MRI differentials for diffuse bilateral white matter signal changes and specific MRI findings described in this report may help in reaching a presumptive diagnosis of this tumor. Case PresentationAn 8-year-old intact male Lagotto Romagnolo was evaluated for a 1-month history of abnormal mental status. Clinical and neurological examination findings included depression, decreased postural reactions in all four limbs, especially on the right side, and decreased menace response in both eyes. During clinical examination the dog had seizures. The medical case was considered to be consistent with a diffuse forebrain lesion. Because of the age of the patient and the absence of hyperthermia neoplasm was considered the most probable cause of neurological signs while inflammation was considered to be less likely. Complete blood count, serum chemistry, and urinalysis results were within normal limits.MRI of the brain was performed under general anesthesia using a 0.25 Tesla permanent magnet (ESAOTE VET-MR GRANDE, Esaote, Genoa, Italy). MRI sequences protocol included Fast Spin Echo T2-weighted images acquired in sagittal and transverse plane, a FLAIR acquired in the transverse plane, and Spin Echo T1-weighted images acquired in the transverse plane before and after intravenous administration of paramagnetic contrast medium (Magnegita-gadopentatedimeglumine 500 mmol/mL-insight agents; 0.15 mmol/kg BW). MRI showed extensive, bilateral, and symmetric T2 and FLAIR hyperintensity of the parietooccipital periventricular and subcortical white matter. The occipital lobes appeared severely involved. The lesions were isointense on T1-weighted images and did not enhance after contrast medium administration (Figures 1 and 2). On sagittal T2-weighted images the aboral part of the corpus callosum lacked homogeneous signal intensity and had illdefined margins (Figure 3). Mass effect or loss of anatomical architecture was not present. Based on the imaging findings toxic-metabolic or degenerative disorders involving white matter (leukoencephalopathy) were considered the main differential diagnoses, while an inflammatory process, either immunomediated or infectious, and a diffuse infiltr...

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“…12 Often considered are demyelinating diseases, inflammatory or infectious processes (for example, progressive multifocal leukencephalopathy), and ischemic changes or leukodystrophia. 24 Vascular leakage and neovascularization are VEGF-dependent processes. 7 In a mouse model with intracerebral human melanoma xenografts, we recently showed that even using high-resolution (7-tesla) MR imaging, VEGF-negative brain metastases are hardly detectable.…”

Section: Discussionmentioning

confidence: 99%

Gliomatosis cerebri: quantitative proof of vessel recruitment by cooptation instead of angiogenesis

Bernsen¹,

Laak²,

Küsters³

et al. 2005

Journal of Neurosurgery

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Please be advised that this information was generated on 2018-05-08 and may be subject to change.LIOMAS are the most common primary brain tumors. Many of these neoplasms, especially astrocytic and oligodendroglial lesions, are characterized by diffuse infiltrative growth in the preexisting brain tissue, accompanied by a more solid component of variable size and intensity. 32 The diffuse infiltrative growth pattern hampers not only radiological/neuroimaging detection and delineation but also topical curative treatment (for example, by surgery or irradiation) of these tumors. Gliomatosis cerebri is a rare neoplasm, defined by the WHO-2000 classification of tumors of the nervous system 13 as a diffuse glial tumor infiltrating the brain extensively, involving more than two lobes, frequently bilaterally, and often extending to infratentorial structures. In some cases, even the entire neural axis might be involved. 5 The prognosis in patients with gliomatosis cerebri is usually poor; according to the WHO-2000 classification, gliomatosis cerebri is considered to represent Grade III malignancy, although long-term survival has been reported in some individuals.Clinically the presentation of gliomatosis cerebri varies widely, ranging from symptoms mimicking vascular disease to mental illness or epileptic manifestations. 1,28 Unfortunately CT and MR imaging characteristics are also nonspecific for this condition, thus making a clinical diagnosis difficult. Histopathologically, one often observes a diffuse and sometimes symmetrical cellular infiltration of glial cells in the preexisting brain tissue with relative preservation of the neuronal architecture.That a gliomatosis cerebri does not usually exhibit enhancement on CT or MR imaging suggests that angiogenesis may not be one of its features. This is in contrast with the notion that most tumors, probably also including high-grade gliomas, require angiogenesis for their growth. 8,23 To establish the role of neovasularization in gliomatosis cerebri, we performed computerized image analyses to assess vessel density and diameter in histological sections of multiple pathological and normal areas of a brain in which a gliomatosis cerebri was present. In addition, the presence of BBB characteristics was investigated in these areas by using immunohistochemical markers (Glut-1 and PgP). To our knowledge, this is the first quantitative study of the vascularity of gliomatosis cerebri. Analysis of our results indicates that angiogenesis was absent in the gliomatosis cerebri, suggesting that tumor growth in these neoplasms is supported by cooptation of the existing vasculature and not by the formation of new vessels. Object. Gliomas are the most common primary brain tumors, many of which (especially astrocytic and oligodendroglial neoplasms) are characterized by diffuse infiltrative growth in the preexisting brain tissue. Gliomatosis cerebri is a rare glial tumor and represents an extreme example of such diffuse infiltrative growth. This growth pattern not only hampers curative treatm...

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Gliomatosis cerebri: findings with computed tomography and magnetic resonance imaging

Cited by 30 publications

References 8 publications

Clinical presentation and surgical management of Glomatosis Cerebri

Clinical presentation and surgical management of Glomatosis Cerebri

Bilateral Telencephalic Gliomatosis Cerebri in a Dog

Gliomatosis cerebri: quantitative proof of vessel recruitment by cooptation instead of angiogenesis

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