Presentation patterns and outcome of gliomatosis cerebri

Rajz,Gustavo  G.; Nass,Dvora; Talianski,Elisa; Pfeffer,Raphael; Spiegelmann,Roberto; Cohen,Zvi  R.

doi:10.3892/ol.2011.445

Presentation patterns and outcome of gliomatosis cerebri

Authors:
- Gustavo G. Rajz
- Dvora Nass
- Elisa Talianski
- Raphael Pfeffer
- Roberto Spiegelmann
- Zvi R. Cohen
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Affiliations: Department of Neurosurgery, Sheba Medical Center, Tel-Ashomer 52621, Israel, Department of Neuropathology, Sheba Medical Center, Tel-Ashomer 52621, Israel, Department of Neuro-Oncology, Sheba Medical Center, Tel-Ashomer 52621, Israel
Published online on: October 18, 2011 https://doi.org/10.3892/ol.2011.445
Pages: 209-213

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Abstract

A total of 25 patients with gliomatosis cerebri (19 males and 6 females; median age 51 years, range 10‑73 years) were diagnosed and treated at the Sheba Medical Center between 1995 and 2009. Of these, 3 patients were 10 years old at the time of diagnosis. Seizures were the initial clinical presentation in 19 patients, focal signs in 16 patients, headaches in 7 patients, cognitive disorder in 4 patients and rapidly progressive hemiparesis in 1 patient. Magnetic resonance imaging (MRI) was performed in the patients and demonstrated a diffuse infiltrative process with a hyperintensity signal on T2-weighted images and a minimal mass effect. Some level of enhancement on MRI was observed in 6 patients. The infiltrative process involved at least two lobes in each patient. Biopsy was performed for diagnosis in the majority of patients. In 1 patient with a markedly rapid deterioration, the diagnosis was established at autopsy. The pathology was compatible with gliomatosis with a diffuse infiltrative low-grade astrocytoma in 21 patients and anaplastic astrocytoma in 5 patients. The patients were treated with whole-brain radiation therapy and 7 patients were treated with combined whole-brain radiation therapy and chemotherapy. Treatment appeared to stabilize 6 patients or improve the clinical condition in 7 patients. Due to the small number of patients in the present study, however, further studies are required to determine the effect of treatment on the natural history of the disease.

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