Small Gliomas: Metabolism and Blood Flow

Abstract

Eight patients with small gliomas (6 low-grade and 2 high-grade) localized in a single gyrus or less than 2 cm diameter were investigated using positron emission tomography and single photon emission computed tomography. All three tumors examined demonstrated hypermetabolism of amino acids. High-grade gliomas demonstrated hypermetabolism of glucose and high blood flow, but normal or low oxygen metabolism. High-grade gliomas also showed accumulation of 201Tl chloride and high or low accumulation of 123I-isopropyl iodoamphetamine. These indications allow preoperative diagnosis of the malignancy of small gliomas, which is important because small gliomas with high-grade malignancy need more extensive removal and adjuvant therapy.

Glial microtumor with 17-year of postoperative follow up

“…Focal epileptic crisis can often outpoint the beginnings of a glioma [1][2][3]6 , as demonstrated in this study. The early stages of development of gliomas in the central nervous system have already been clearly described.…”

“…From these 8 patients, 5 presented epileptic crisis only. Tamura et al 3 described also 8 cases of small gliomas, 6 of them were benign and two malignant. Tumors were located in separate gyrus and measured less than 20 mm.…”

“…Reports about biological behavior of gliomas most commonly describe the latest stages of their natural course [1][2][3] . However, studies about the earliest stages of human astrocytomas are rare.…”

“…Identification of microscopic foci of astrocytic cells at the primary phase of a glioma is extremely rare. Tamura et al 3 reported that whereas the majority of small gliomas tends to be benign and malignant tumors invade neighboring tissues early on their development. Rubinstein 4 reported that the most primitive cells of the reticular system found in the meninges and perivascular sheaths of cerebral vessels, along with the microglia, originate the reticular cell sarcoma (microglioma group).…”

Glial tumourettes (glial microtumours): Their clinical and histopathological manifestations

“…These large tumours are considered to represent the later period of their natural history, and there have been few reports on the early stage of glioma development [22,24,32]. Due to advances in such diagnostic neuro-imaging techniques as computed tomography (CT) and magnetic resonance imaging (MRI), however, our experiences with minute gliomas or glial tumourettes, which may represent an early stage of gliomas, have substantially increased in recent years.…”