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Review
. 2022 Feb;50(2):3000605221079544.
doi: 10.1177/03000605221079544.

Multiple occult intracranial diseases diverted diagnosis of glioma in a patient

Xin Long Li  1 , Ao Zhan  1 , Lin Yue  1 , Xiaoli Zhang  1 , Zheng Hong Wei  1
Affiliations
Review

Multiple occult intracranial diseases diverted diagnosis of glioma in a patient

Xin Long Li et al. J Int Med Res. 2022 Feb.

Abstract

Dizziness is an atypical symptom of the nervous system. Many neurological disorders can manifest as dizziness. When patients have multiple neurological disorders, the most obvious diagnosis is often considered, and diseases that are potentially more deadly are overlooked. Here, we report the case of a man aged in his early 50s with dizziness who was found to have four neurological disorders. A series of treatments failed to resolve the condition. A review of this case highlights that when a patient's symptoms are not typical, a comprehensive examination and evaluation is required to determine the etiology, and imaging may reveal further minor problems.

Keywords: Glioma; Rathke cleft cyst; dizziness; dural arteriovenous fistula; glioblastoma multiforme; intracranial calcification.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Imaging examinations from 12 January to 2 February 2018. (a) A T1-weighted magnetic resonance image of the neck (12 January 2018) shows probable mild posterior herniation of four to five cervical discs with suspicious space-occupying lesions in the saddle area of the sella turcica. (b) Enhanced magnetic resonance image (15 January 2018) of the saddle region displays a probable Rathke cleft cyst, which was confirmed by the postoperative pathology results. (c) Initial postoperative head computed tomography (CT) (17 January 2018) shows a small high-density shadow in the right lateral cleft of the saddle area. (d) Head CT (2 February 2018) shows a high-density shadow on the right temporal lobe.
Figure 2.
Figure 2.
Postoperative pathology examinations from 15 January 2018 to December 2019. (a) Rathke cyst (15 January 2018). (b) Grade II glioma (14 September 2018). (c) Glioblastoma (December 2019).
Figure 3.
Figure 3.
Images of the dural arteriovenous fistula. (a, b) Head computed tomography (CT) angiography. (c) CT venography indicates a right frontal malformation. (d) Digital subtraction angiography displays a dural arteriovenous fistula of the right forehead.
Figure 4.
Figure 4.
The temporal lesion was found. (a) 14 September 2018; head computed tomography led to suspicion of a right frontal and temporal lobe hemorrhage of approximately 20 mL. The previous temporal lobe lesions had expanded and were now more characteristic of tumors. (b, c, d) Cranial enhanced magnetic resonance imaging plus magnetic resonance spectroscopy. (b) T1-weighted magnetic resonance image of the head. (c) T2-weighted image. (d) Fluid-attenuated inversion recovery. (e) Enhanced T1 weighted image.
Figure 5.
Figure 5.
Image of glioma recurrence. (a) A second T1-weighted enhanced magnetic resonance image of the head. (b) T2-weighted image. (c) Fluid-attenuated inversion recovery. (d) Enhanced T1 weighted image.
See this image and copyright information in PMC

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