Cystoid angiocentric glioma: A case report and literature review

Abstract

Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.

Keywords: Angiocentric glioma; Epilepsy; Magnetic resonance imaging; Neuroepithelial tumor; Temporal lobe.

Figure 1

25-year-old male with angiocentric glioma in the right frontal lobe. Findings: Noncontrast axial CT scan demonstrates a low density lesion (arrow) involving the right frontal region. There is a small area of calcification (CT value=116 HU) located anterior to the lesion (arrowhead). Technique: Siemens (SOMATOM Emotion) 16-slice multidetector CT, sequential axial, 270 mAs, 130 kVp, 4.8 mm slice thickness.

Figure 2

25-year-old male with angiocentric glioma in the right frontal lobe. Findings: Axial T1WI (T1-FLAIR) (A), FLAIR (B) and T2WI (C) demonstrate a relatively well defined cystoid lesion (arrow) that is hypo-intense on T1WI and FLAIR image, and hyper-intense on T2WI. There are no diffusion restrictions on DWI (D). The small area of calcification (arrowhead) anterior to the cystoid lesion is isointense on T1WI, hypo-intense on FLAIR image, T2WI and DWI. Technique: 3.0T Signa HD (GE, USA) MR scanner. 5.0mm slice thickness. T1WI (T1-FLAIR): TR=2580ms, TE=16ms, TI=860ms. FLAIR: TR=9000ms, TE=155ms, TI=2250ms. T2WI: TR=3280ms, TE=108ms. DWI: b-value =0 and 1000 s/mm2, TR=5300ms, TE=75ms.

Figure 3

25-year-old male with angiocentric glioma in the right frontal lobe. Findings: A. Axial T1WI (T1-FLAIR) demonstrates a hyper-intense “rim” around the lesion (arrow). There is no significant mass effect. B. Coronal T2WI shows an ovoid lesion (1.7cm×1.3cm×1.0cm) perpendicular to the cerebral ventricle (arrow). Technique: 3.0T Signa HD (GE, USA) MR scanner. 5.0mm slice thickness. T1WI (T1-FLAIR): TR=2580ms, TE=16ms, TI=860ms. T2WI: TR=3280ms, TE=108ms.

Figure 4

25-year-old male with angiocentric glioma in the right frontal lobe. Findings: A. Coronal postcontrast T1WI (T1-FLAIR) demonstrates a well defined non-enhancing lesion located in the sub-cortical white matter (arrow). B. Sagittal postcontrast T1WI demonstrates a small non-enhancing area of calcification (arrowhead) anterior to the lesion (arrow). Technique: 3.0T Signa HD (GE, USA) MR scanner. 5.0mm slice thickness. T1WI (T1-FLAIR): TR=2580ms, TE=16ms, TI=860ms. Contrast material and dose: Gadolinium 0.2ml/Kg.

Figure 5

25-year-old male with angiocentric glioma in the right frontal lobe. Findings: A. There is no evidence of tumor recurrence on three months follow-up postcontrast TIWI (T1-FLAIR) (arrow). B. Histopathology examination showed that bipolar single cells were centered around the blood vessels (arrow). Technique: 3.0T Signa HD (GE, USA) MR scanner. 5.0mm slice thickness. T1WI (T1-FLAIR): TR=2580ms, TE=16ms, TI=860ms. Contrast material and dose: Gadolinium 0.2ml/Kg.b) Posterior view shows abnormal increased uptake in the left parotid gland (arrow).