We present a case of diffuse astrocytoma mimicking the radiological features of Neuro-Behcet’s disease. A 61 year old man presented with a progressive asymmetric brainstem syndrome (left>right). Examination of cranial nerves revealed a left lateral rectus palsy, a left trigeminal sensory loss V1-V3 and left lower motor facial palsy. There were no oral or genital ulcerations, no ophthalmic symptoms or signs and no skin rashes. MR imaging showed an asymmetric mesencephalic- diencephalic hyperintensity on T2 without contrast enhancement. Cerebrospinal fluid was within normal limits including large volume cytological exam. Whole body CT and FDG-PET demonstrated no evidence of malignancy. IV methylprednisolone (1g daily) for three days was given then a 60mg prednisolone taper.He subsequently developed a right hemiparesis and was found to have on repeat MR brain a new right prefrontal cortex lesion involving the middle frontal lobe, without contrast enhancement. Biopsy showed a IDH-1 wild-type diffuse astrocytoma. He was administered chemotherapy and whole brain radiotherapy with no interval changes at 2 month follow up. Our case highlights a rare and important presentation of diffuse astrocytoma masquerading as rhombencephalitis syndrome. Timely brain biopsy allows for prompt intervention and improved performance status.christopherleahy@doctors.org.uk61
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.