[Cerebral gliomatosis with development of multifocal glioblastoma]

Abstract

Introduction: Cerebral gliomatosis (CG) is a diffuse infiltrating glial neoplasia which may affect any part of the central nervous system (CNS). Its diffuse infiltrating growth leads to difficulty with clinical suspicion and imaging technique diagnosis. Magnetic resonance (MR) is more sensitive than computerized tomography (CT) for the detection of lesions. However, the extent of the infiltration may be roughly evaluated using current imaging techniques.

Objective: In this article we describe histological aspects of this rare condition, its biological behavior and correlation with radiological findings, and review the contribution of other techniques (positron emission tomography, immunohistochemical examination) in its diagnosis and delimitation.

Clinical case: We present a case of CG in a 26 year old man. On CT no alterations were seen. On MR there was diffuse involvement of the white matter extending to the cortex. The patient worsened rapidly and later developed two focal masses of glioblastoma multiform in areas with the most neoplastic infiltration.

Conclusions: MR is more useful than CT in establishing the diagnosis and extent of CG. Although it is a rare condition, it should be included in the differential diagnosis of conditions which affect the white matter in a diffuse manner. Poor delimitation between white and grey matter helps in diagnosis of this condition.