Multiple craniotomies in the management of multifocal and multicentric glioblastoma

Hassaneen, Wael; Levine, Nicholas B.; Suki, Dima; Salaskar, Abhijit; Lima, Alexandro; McCutcheon, Ian E.; Prabhu, Sujit S.; Lang, Frederick F.; DeMonte, Franco; Rao, Ganesh; Weinberg, Jeffrey S.; Wildrick, David M.; Aldape, Kenneth; Sawaya, Raymond

doi:10.3171/2010.6.jns091326

Cited by 85 publications

(78 citation statements)

References 40 publications

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“…Previous studies have suggested a fairly similar incidence of multifocal and multicentric tumours [1,16,17]. Our results demonstrate, however, that the majority of glioblastomas with multiple enhancing regions are multifocal rather than multicentric, with apparently true multicentricity being rare.…”

Section: Discussioncontrasting

confidence: 62%

Multifocal and multicentric glioblastoma: Improved characterisation with FLAIR imaging and prognostic implications

Lasocki

Gaillard

Tacey

et al. 2016

Journal of Clinical Neuroscience

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Section: Discussioncontrasting

confidence: 62%

Multifocal and multicentric glioblastoma: Improved characterisation with FLAIR imaging and prognostic implications

Lasocki

Gaillard

Tacey

et al. 2016

Journal of Clinical Neuroscience

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“…For instance, high-grade gliomas have been shown to present heterogeneous signal areas, contrast-enhancing masses, necrosis, and cyst degeneration. [8][9][10] In addition, the intensity of a DWI signal also reflects the pathological grading of MCG lesions. For example, high-grade gliomas often present a high signal on DWI, which could be related to the active proliferation of tumor cells or densely arranged tumor cells.…”

Section: Discussionmentioning

confidence: 99%

The Novel Features of Multiple Cerebral Gliomas on Magnetic Resonance Imaging

Zhang¹,

Li²,

Niu³

et al. 2015

j med imaging hlth inform

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Magnetic resonance imaging (MRI) is the golden standard for visualizing brain tumors. Cytotoxic edema and tumor angiogenesis characterize high-grade gliomas. Diffusion-weighted imaging (DWI) and contrast-enhanced scanning aid in estimating the blood supply to the tumor and the cytotoxic edema. The aim of the study was to characterize the histological grading of multiple cerebral gliomas (MCG) and the primary area affected by MCG via studying radiographic appearances by MRI imaging, including DWI signal, predilection site, and contrastenhanced scanning. Nineteen patients with MCG received MRI and contrast-enhanced MRI scanning prior to surgery. Twenty-six lesions from 20 patients included: seven astrocytomas (grade I-II) (7/26 lesions, 27%), 14 anaplastic astrocytomas (grade III) (14/26 lesions, 54%), and five glioblastomas (grade IV) (5/26 lesions, 19%). The hippocampus (hippocampal gyrus) was identified as the area most affected by the MCG in 14 of the patients (14/20 patients, 70%). In conclusion, the intensity of the DWI signal, the degree of enhancement, and the differentiation degree in the different MCG-affected areas in the same patient were inconsistent, and the progression of each lesion was varied. DWI and contrast-enhanced MRI scanning can aid in distinguishing high versus low-grade glioma. Furthermore, the results of the DWI and contrast-enhanced scanning were related to the glioma grade: a stronger DWI signal and contrast-enhanced scanning were observed in grade III-IV gliomas as compared to grade I-II gliomas. The anaplastic astrocytoma was the most common histological type, and the hippocampus (hippocampal gyrus), as a special area affected by MCG, should be noted.

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“…Certain MRI features such as variable lesion morphology, mild peritumoral edema, and irregular tumor margins can suggest the diagnosis of multifocal or multicentric GBM [12][13][14]. Since metastasis from extracranial primary tumors is the most common diagnosis associated with multiple brain masses, histopathological verification is imperative before making a diagnosis of metastasis, especially in patients with no known primary neoplasm [3,11].…”

Section: Discussionmentioning

confidence: 99%

Rare Case Report of Multicentric Glioblastoma Multiforme Initially Mimicking With Herpes Simplex Encephalitis on MRI and Its Progression on Serial Imaging

Singh¹,

Bharat²,

Narendra³

et al. 2016

J Med Cases

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We report a case of a 58-year-old man with multicentric glioblastoma initially presenting as acute encephalitic illness. He presented with seizures and cognitive impairment in the emergency department of our hospital. Initially clinical and brain MRI findings were in favor of herpes simplex virus (HSV) encephalitis. The patient had initially improved after medical treatment. After 3 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increase in size of lesions and surrounding perilesional edema in the bilateral frontal lobes, cingulate gyrus and left insular cortex on T2-weighted images and lesions showed enhancement on post-contrast T1-weighted images. Patient underwent right frontal craniotomy and resection of lesion in right frontal region. The treatment is surgery or palliative, and management is controversial. The prognosis, however, remains unfavorable. Therefore, in elderly patients presenting with multifocal lesions on MRI of brain or atypical encephalitic symptoms, the rare possibility of multicentric glioblastoma multiforme should be considered as differential diagnosis.

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Multiple craniotomies in the management of multifocal and multicentric glioblastoma

Cited by 85 publications

References 40 publications

Multifocal and multicentric glioblastoma: Improved characterisation with FLAIR imaging and prognostic implications

Multifocal and multicentric glioblastoma: Improved characterisation with FLAIR imaging and prognostic implications

The Novel Features of Multiple Cerebral Gliomas on Magnetic Resonance Imaging

Rare Case Report of Multicentric Glioblastoma Multiforme Initially Mimicking With Herpes Simplex Encephalitis on MRI and Its Progression on Serial Imaging

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