Pontine Ring-Enhancing Glioblastoma Multiforme–Like Fungal Abscess

Province, Paula; Hackney, James R.; Palmer, Cheryl A.; Guthrie, Barton L.; Fathallah‐Shaykh, Hassan M.

doi:10.1001/archneurol.2011.755

Arch Neurol

2011

DOI: 10.1001/archneurol.2011.755

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Pontine Ring-Enhancing Glioblastoma Multiforme–Like Fungal Abscess

Paula Province

James R. Hackney²,

Cheryl A. Palmer³

et al.

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Cited by 3 publications

(2 citation statements)

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“…This practice is potentially problematic because it is not always possible to definitively distinguish glioblastoma from cerebral metastases, abscesses, inflammatory diseases, or other ring-enhancing intracranial lesions. 3,4,15,23 In 1 study, nearly 20% of radiographic lesions believed to be glioblastoma by experienced neuroradiologists were found to be cerebral abscesses or cerebral metastases at the time of biopsy. 23 To the extent that effective treatments exist for many diagnoses that present as ringenhancing intracranial lesions, we propose that glioblastoma treatment be performed only after tissue diagnosis, particularly given the overall safety of needle-based stereotactic biopsies.…”

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confidence: 99%

Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis

Noorbakhsh¹,

Tang²,

Marcus³

et al. 2014

JNS

114

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Object There is limited information on the relationship between patient age and the clinical benefit of resection in patients with glioblastoma. The purpose of this study was to use a population-based database to determine whether patient age influences the frequency that gross-total resection (GTR) is performed, and also whether GTR is associated with survival difference in different age groups. Methods The authors identified 20,705 adult patients with glioblastoma in the Surveillance, Epidemiology, and End Results (SEER) registry (1998–2009). Surgical practice patterns were defined by the categories of no surgery, subtotal resection (STR), and GTR. Kaplan-Meier and multivariate Cox regression analyses were used to assess the pattern of surgical practice and overall survival. Results The frequency that GTR was achieved in patients with glioblastoma decreased in a stepwise manner as a function of patient age (from 36% [age 18–44 years] to 24% [age ≥ 75]; p < 0.001). For all age groups, glioblastoma patients who were selected for and underwent GTR showed a 2- to 3-month improvement in overall survival (p < 0.001) relative to those who underwent STR. These trends remained true after a multivariate analysis that incorporated variables including ethnicity, sex, year of diagnosis, tumor size, tumor location, and radiotherapy status. Conclusions Gross-total resection is associated with improved overall survival, even in elderly patients with glioblastoma. As such, surgical decisions should be individually tailored to the patient rather than an adherence to age as the sole clinical determinant.

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mentioning

confidence: 99%

Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis

Noorbakhsh¹,

Tang²,

Marcus³

et al. 2014

JNS

114

View full text Add to dashboard Cite

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“…The differential diagnosis of these lesions ranges from nontumoral lesions, such as ischemia, demyelinating disease, vascular malformation, abscess, radionecrosis, tuberculoma and granuloma, to benign or malignant tumors, such as epidermoid cysts, metastatic tumors, and lymphoma, among others [12][13][14][15][16][17][18] .…”

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confidence: 99%

Impact of histological diagnosis on the treatment of atypical brainstem lesions

Dellaretti

Câmara

Ferreira

et al. 2020

Sci Rep

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For atypical brainstem lesions, histological diagnosis can have an impact on treatment, especially in cases where diffuse glioma is not found. Since radiotherapy is the only therapeutic modality that has shown clinical and radiographic improvement in patients with diffuse glioma, the misdiagnosis of diffuse glioma can have drastic consequences, particularly in patients with nontumorous lesions. Thus, the purpose of this study was to evaluate the impact of histological diagnosis on the treatment of atypical brainstem lesions. This was a retrospective study of 31 patients who underwent biopsy of atypical brainstem lesions. The procedures were performed between January 2008 and December 2018 at the Life Center Hospital and Santa Casa de Belo Horizonte, MG, Brazil. A diagnosis was obtained in 26 (83.9%) cases. Three patients presented complications: one presented bleeding with no clinical repercussions and two showed worsening of neurological deficit, only one of which was definitive. No mortality occurred due to the procedure. The histological diagnosis was diffuse glioma in seven cases (22.6%) and not diffuse glioma in 19 cases (61.3%). Thus, the histological diagnosis had an impact on the treatment of 19 patients (treatment impact rate: 61.3%). The histological diagnosis of intrinsic brainstem lesions is a safe, efficient procedure with a high diagnosis rate, and as such, it should be considered in the management of atypical lesions.

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Intracranial Infectious and Inflammatory Diseases Presenting as Neurosurgical Pathologies

Rapalino

Mullins

2017

NEUROSURGERY

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There are many infectious and inflammatory processes affecting the central nervous system that can simulate other neurosurgical pathologies (e.g. tumor) and may precipitate a brain biopsy for definitive diagnosis if not suspected a priori. The challenge for the healthcare team is to recognize imaging features that support a nonsurgical pathology to avoid unnecessary interventions. This review aims to give a general overview of some common inflammatory and infectious entities that affect the central nervous system, with illustrative examples and highlighting important pearls and pitfalls.

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Pontine Ring-Enhancing Glioblastoma Multiforme–Like Fungal Abscess

Cited by 3 publications

References 2 publications

Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis

Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis

Impact of histological diagnosis on the treatment of atypical brainstem lesions

Intracranial Infectious and Inflammatory Diseases Presenting as Neurosurgical Pathologies

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