An 8-year-old intact male Lagotto Romagnolo was presented with forebrain signs. Neuroanatomic localization was diffuse prosencephalon. MRI revealed diffuse, bilateral, and symmetric T2 and FLAIR hyperintensities in the parieto-occipital white matter and corpus callosum. No mass effect or contrast enhancement was noted. Analysis of cerebrospinal fluid revealed normal protein content and mild mononuclear pleocytosis. Atypical cells were not identified. 15 days later because of the worsening of clinical condition the patient was euthanized upon owner's request. Neuropathological investigations were consistent with gliomatosis cerebri (GC). Such an unusual imaging pattern appeared similar to some cases of human GC and to a previous reported case in a dog, suggesting a possible repeatable imaging findings for this rare brain neoplasm. GC should be included in the MRI differentials for diffuse bilateral white matter signal changes and specific MRI findings described in this report may help in reaching a presumptive diagnosis of this tumor.
Case PresentationAn 8-year-old intact male Lagotto Romagnolo was evaluated for a 1-month history of abnormal mental status. Clinical and neurological examination findings included depression, decreased postural reactions in all four limbs, especially on the right side, and decreased menace response in both eyes. During clinical examination the dog had seizures. The medical case was considered to be consistent with a diffuse forebrain lesion. Because of the age of the patient and the absence of hyperthermia neoplasm was considered the most probable cause of neurological signs while inflammation was considered to be less likely. Complete blood count, serum chemistry, and urinalysis results were within normal limits.MRI of the brain was performed under general anesthesia using a 0.25 Tesla permanent magnet (ESAOTE VET-MR GRANDE, Esaote, Genoa, Italy). MRI sequences protocol included Fast Spin Echo T2-weighted images acquired in sagittal and transverse plane, a FLAIR acquired in the transverse plane, and Spin Echo T1-weighted images acquired in the transverse plane before and after intravenous administration of paramagnetic contrast medium (Magnegita-gadopentatedimeglumine 500 mmol/mL-insight agents; 0.15 mmol/kg BW). MRI showed extensive, bilateral, and symmetric T2 and FLAIR hyperintensity of the parietooccipital periventricular and subcortical white matter. The occipital lobes appeared severely involved. The lesions were isointense on T1-weighted images and did not enhance after contrast medium administration (Figures 1 and 2). On sagittal T2-weighted images the aboral part of the corpus callosum lacked homogeneous signal intensity and had illdefined margins (Figure 3). Mass effect or loss of anatomical architecture was not present. Based on the imaging findings toxic-metabolic or degenerative disorders involving white matter (leukoencephalopathy) were considered the main differential diagnoses, while an inflammatory process, either immunomediated or infectious, and a diffuse infiltr...