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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
MULTI-CENTRIC GLIOMA MIMICKING MULTIPLE SCLEROSIS
Author
1Idoia Corcuera-Solano, 2Margaret Pain, 2Irene Bolignari, 3Mary Fowkes and 2Isabelle M Germano
Email
isabelle.germano@mountsinai.org
keyword
multifocal glioma, multiple sclerosis, stereotactic biopsy, high grade gliomas
Abstract
High-grade gliomas (HGG) and multiple sclerosis (MS) can be multi-focal and have similar radiographic appearance making neurosurgical intervention imperative to establish correct diagnosis and appropriate treatment. The authors describe a 44 years old male who presented with a left facial weakness. Magnetic resonance imaging (MRI) demonstrated several T2-weighted image and FLAIR hyperintensity lesions, as well as a large cystic lesion within the right basal ganglia with mild peripheral bright T2-weighted image and FLAIR signal. CSF was negative for viral antibodies and oligoclonal bands; IgG were normal. A clinical diagnosis of MS was made and the patient prescribed prednisone. Six months after symptoms’ onset, the patient’s weakness progressed to a left hemiparesis. A repeated brain MRI demonstrated an increase in size of the cystic lesion and faintly ring enhancement. Additional hyperintense lesions in the left centrum semiovale and throughout the corpus callosum were seen. MR perfusion images showed increased blood flow and blood volume within the superior aspect of the right basal ganglia. A brain biopsy revealed an anaplastic astrocytoma WHO III. This report highlights the importance of tissue diagnosis when radiographic appearance is not definitive and treatment strategies for MS are not successful.
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