Abscess within a Glioblastoma: Mimicking a Matryoshka Doll

Kishore, K.R.; Beniwal, Manish; Rao, Shilpa; Rao, K.V.L. Narasinga; Vazhayil, Vikas; Srinivas, Dwarakanath; Somanna, Sampath

doi:10.1016/j.wneu.2018.02.036

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Our case seems to be unusual in this aspect as a florid granulation tissue response was seen with an attempt to wall off the necrotic zone. A thorough examination of histology slides failed to detect any concomitant infectious agents responsible for such a response as reported rarely in the literature [9] .…”

Section: Discussionmentioning

confidence: 82%

Glioblastoma Mimicking an Abscess: A Radio-Pathological Case Report

Malhotra¹

2020

IJMLR

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Glioblastoma is an aggressive malignant glial neoplasm of the CNS with a dismal prognosis. It often presents as a ring enhancing lesion on imaging and if accompanied by abundant necrosis, it can often be misinterpreted as an abscess. Even on a histological examination, in the background of predominantly necrosis, the neoplasm might be missed without a thorough evaluation. This case had a similar presentation accompanied by an exuberant granulation tissue response mimicking an abscess, however no organism was found. A detailed radiological, pathological and microbiological evaluation is presented.

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Section: Discussionmentioning

confidence: 82%

Glioblastoma Mimicking an Abscess: A Radio-Pathological Case Report

Malhotra¹

2020

IJMLR

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“…Among the eight similar reports documented in literature ( Table 1 ), 1 11 12 13 14 15 16 17 none of the cases were diagnosed as different entities on radiology presurgery. All but one case showed a solitary organism detected in the abscess.…”

Section: Discussionmentioning

confidence: 85%

Intratumoral and Peritumoral Brain Abscess Concomitant with Glioblastoma: Report of Two Cases with Review of Literature

et al. 2022

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Intracranial abscess coexistent with a high grade glioma, without prior surgical intervention, is an unusual occurrence. This paper presents two such cases with Nocardia farcinica abscess surrounding the glioblastoma in an immunocompromised individual and Enterococcus faecium abscess within the glioblastoma in an immunocompetent patient. Adjuvant therapy was tapered as per each patient's clinical response. Till date, only eight cases of coexistent high-grade glioma and brain abscess have been reported in literature. This report stands distinct in highlighting the need to radiologically evaluate each foci of a multicentric cranial lesion on its own merit.

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“…Accounting for competing risk of death, the 1-, 5-, 10-, and 35year cumulative incidence of cancer was 7% (95% CI 6-8), 11% (95% CI 9-12), 13% (95% CI 11-15), and 24% (95% CI 20-27) in patients with brain abscess compared with 0.7% (95% CI 0.6-0.9), 4% (95% CI 4-5), 8% (95% CI 8-9), and 25% (95% CI [23][24][25][26][27] in the matched comparison cohort (Figure 2). The cumulative incidence of CNS and eye cancer in patients with brain abscess showed that almost all were diagnosed around time of the index date.…”

Section: Resultsmentioning

confidence: 98%

“…22,23 CNS cancers may also constitute a suitable nidus for abscess formation after transient bacteremia, e.g., during toothbrushing. [24][25][26] In consequence, some of these patients likely presented with brain abscess as a complication to undiagnosed CNS or other cancers and once source control was obtained, patients were subsequently diagnosed with cancer. In addition, neurosurgery has been shown to be a substantial risk factor for brain abscess, although the absolute risk is low, and some of these patients may have developed brain abscess due to preceding neurosurgical procedures during the diagnostic workup for CNS or eye cancer.…”

Section: Discussionmentioning

confidence: 99%

Brain Abscess and Risk of Cancer

et al. 2022

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Background and objectives:Underlying occult cancer could potentially explain some of the observed increased long-term mortality among brain abscess patients.Methods:Nationwide, population-based healthcare registries were used to examine long-term risks of cancer in brain abscess patients from 1982 through 2016 compared with a population comparison cohort individually matched (10:1) on age, sex, and residence. Cumulative incidences and adjusted cause-specific hazard rate ratios (HRR) with 95% confidence intervals (CIs) for cancer were computed. Potential confounding by family-related factors was explored by comparing cumulative incidences of cancer among siblings of both groups.Results:Among 1,384 brain abscess patients (37% female, median age 50 years, IQR 33-63), cancer was observed in 218 (16%) compared with 1,657/13,838 (12%) in the comparison cohort yielding an adj. HRR of 2.09 (95% CI 1.79-2.45). Median time to diagnosis of cancer was 1.8 years (IQR 0.02-9.1) in brain abscess patients and 8.6 years (IQR 3.9-15.9) in comparison cohort. Among brain abscess patients, central nervous system and eye cancer was diagnosed in 59 (4.3%), of which 47/59 (80%) occurred within 90 days of the admission date, metastasizing cancer in 54 (3.9%), respiratory tract cancer in 48 (3.5%), and gastro-intestinal cancer in 36 (2.6%). Results remained consistent in almost all subgroups and in sensitivity analyses. Accounting for competing risk of death, the 1-, 5-, 10-, and 35-year cumulative incidence of cancer was 7% (95% CI 6-8), 11% (95% CI 9-12), 13% (95% CI 11-15), and 24% (95% CI 20-27) in brain abscess patients compared with 0.7% (95% CI 0.6-0.9), 4% (95% CI 4-5), 8% (95% CI 8-9), and 25% (95% CI 23-27) in the comparison cohort. The cumulative incidences of cancer among siblings of brain abscess patients was 10% and 12% among siblings of the comparison cohort.Discussion:Brain abscess was associated with substantially increased risk of cancer during the first ten years after diagnosis.

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Abscess within a Glioblastoma: Mimicking a Matryoshka Doll

Cited by 6 publications

References 32 publications

Glioblastoma Mimicking an Abscess: A Radio-Pathological Case Report

Glioblastoma Mimicking an Abscess: A Radio-Pathological Case Report

Intratumoral and Peritumoral Brain Abscess Concomitant with Glioblastoma: Report of Two Cases with Review of Literature

Brain Abscess and Risk of Cancer

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