Primary Diffuse Leptomeningeal Gliomatosis: Radiological/Pathological Features

Ahmad, Ehtasham; Mohamed, Mohamed; Vrettos, Apostolos

doi:10.1155/2016/5016840

Cited by 4 publications

(4 citation statements)

References 11 publications

(13 reference statements)

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“…In moyamoya disease, diffuse leptomeningeal enhancement is scarce, which is caused by an engorged pial network via leptomeningeal anastomosis [ 32 ]. Other neoplasms characterised by diffuse leptomeningeal enhancement consist of primary diffuse leptomeningeal gliomatosis and diffuse leptomeningeal glioneuronal neoplasm [ 8 , 33 ]. Notwithstanding, the main imaging differential diagnosis of DLGNTs includes chronic infectious meningitis, tuberculous meningitis, sarcoidosis, leptomeningeal intraparenchymal diffuse astrocytoma, and pilocytic astrocytoma.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Leptomeningeal Glioneuronal Tumour with 9-Year Follow-Up: Case Report and Review of the Literature

et al. 2022

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In 2016, the World Health Organisation Classification (WHO) of Tumours was updated with diffuse leptomeningeal glioneuronal tumour (DLGNT) as a provisional unit of mixed neuronal and glial tumours. Here, we report a DLGNT that has been re-diagnosed with the updated WHO classification, with clinical features, imaging, and histopathological findings and a 9-year follow-up. A 16-year-old girl presented with headache, vomiting, and vertigo. Magnetic resonance imaging (MRI) demonstrated a hyperintense mass with heterogenous enhancement in the right cerebellopontine angle and internal auditory canal. No leptomeningeal involvement was seen. The histological examination revealed neoplastic tissue of moderate cellularity formed mostly by oligodendrocyte-like cells. Follow-up MRI scans demonstrated cystic lesions in the subarachnoid spaces in the brain with vivid leptomeningeal enhancement. Later spread of the tumour was found in the spinal canal. On demand biopsy samples were re-examined, and pathological diagnosis was identified as DLGNT. In contrast to most reported DLGNTs, the tumour described in this manuscript did not present with diffuse leptomeningeal spread, but later presented with leptomeningeal involvement in the brain and spinal cord. Our case expands the spectrum of radiological features, provides a long-term clinical and radiological follow-up, and highlights the major role of molecular genetic testing in unusual cases.

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Section: Discussionmentioning

confidence: 99%

Diffuse Leptomeningeal Glioneuronal Tumour with 9-Year Follow-Up: Case Report and Review of the Literature

et al. 2022

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“…Moyamoya disease seldom show diffuse leptomeningeal enhancement [9]. Other entities exhibiting diffuse leptomeningeal enhancement include primary diffuse leptomeningeal gliomatosis and diffuse leptomeningeal glioneuronal tumor [6,10]. We underscore the need for suspicion of DLGNT/DLGNT-like neoplasms in such cases demonstrating thick and nodular meningeal enhancement, as it has a bearing on the treatment approaches.…”

Section: Discussionmentioning

confidence: 76%

Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report

Peer

Murumkar

Kulanthaivelu

et al. 2021

Egypt J Radiol Nucl Med

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Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimaging with associated communicating hydrocephalus is usually suggestive of infective meningitis and the patients are started on empirical anti-microbial therapy. However, it is important to consider other differential diagnosis of leptomeningeal enhancement in such cases, particularly if the clinical condition does not improve on anti-microbial therapy. An early diagnosis of a neoplastic etiology may be of particular importance as the treatment regimens vary considerably depending on the underlying disease condition. Case presentation In this case report, we describe a case of DLGNT with high-grade histopathological features which was initially managed as tubercular meningitis based on the initial neuroimaging findings. Due to worsening of the clinical course and subsequent imaging findings at follow-up, a diagnosis of DLGNT was considered and subsequently proven to be DLGNT with features of anaplasia on histopathological examination of leptomeningeal biopsy specimen. Conclusion This case highlights the importance of recognizing certain subtle finding on MRI which may help in an early diagnosis of DLGNT which is crucial for appropriate treatment.

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“…Because of the small number of cases reported in the literature due to the low incidence of GBM with direct cranial nerve involvement and no cases of gliosarcoma, sometimes this kind of lesion is not considered and is misdiagnosed, both during preoperative diagnostic evaluation and during the surgery, hypothesizing the tumor origin from the nerve with secondary extension to the near brain parenchyma, or from heterotopic neuroglial cell dissemination from leptomeningeal gliomas or gliomatosis [29] , or from primary brainstem GBM with extension along adjacent cranial nerve.…”

Section: Discussionmentioning

confidence: 99%

Gliosarcoma with direct involvement of the oculomotor nerve: Case report and literature review

Corvino¹,

Peca²,

Corazzelli³

et al. 2022

Radiology Case Reports

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Gliosarcoma is a rare malignant brain tumor, characterized by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. We first report a case of temporo-mesial gliosarcoma, extended to the crural and ambient cisterns, with direct involvement of the ipsilateral third cranial nerve and encasement of anterior choroidal, posterior communicant and posterior cerebral arteries, presenting without symptoms of peripheral neuropathy. A 61-year-old woman with 1-month history of intense bilateral frontal-temporal headache resistant to pharmacological therapy and paresis of the left lower midface underwent surgical resection, through pterional trans-sylvian approach, of a right temporo-mesial gliosarcoma which directly involved the ipsilateral oculomotor nerve. Reported cases of gliomas with direct involvement of a cranial nerve, from the third to the twelfth, are very rare, whit no cases of gliosarcoma described. Because of its rarity, sometimes this entity is not considered as diagnostic hypothesis and is misdiagnosed, both during preoperative diagnostic evaluation and during the surgery. Gliosarcoma is a strong challenge for neurosurgeons and neurooncologists because of low incidence, poor prognosis and limited reported cases on literature. This case shows unique features for localization, pattern of growth and clinical presentation.

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Primary Diffuse Leptomeningeal Gliomatosis: Radiological/Pathological Features

Cited by 4 publications

References 11 publications

Diffuse Leptomeningeal Glioneuronal Tumour with 9-Year Follow-Up: Case Report and Review of the Literature

Diffuse Leptomeningeal Glioneuronal Tumour with 9-Year Follow-Up: Case Report and Review of the Literature

Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report

Gliosarcoma with direct involvement of the oculomotor nerve: Case report and literature review

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