Glioblastoma multiforme masquerading as pseudotumor cerebri. Case report.
A 16-year-old girl developed headaches and bilateral papilledema while taking minocycline for acne. The initial neuro-ophthalmologic evaluation was normal except for enlarged blind spots OU. An MRI scan demonstrated subtle abnormalities. A lumbar puncture was entirely normal except for an increased opening pressure. A tentative diagnosis of pseudotumor cerebri was made and the patient was treated with Diamox. A second MRI was unchanged, and a lumbar puncture performed while the patient was taking Diamox was entirely normal. The patient subsequently lost vision in both eyes, and a third MRI now revealed a supracellar enhancing mass. Biopsy and subtotal resection of the mass showed it to be a glioblastoma multiforme. This case emphasizes pitfalls in the diagnosis of pseudotumor cerebri. Careful follow-up and a high index of suspicion in pseudotumor cerebri syndromes are essential.
Neuro-Ophthalmology Unit, Johns Hopkins Medical Institution, Baltimore, Maryland.
M
M
Aroichane
N R
NR
Miller
E R
ER
Eggenberger
D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D005654:Fundus Oculi; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D005909:Glioblastoma / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008911:Minocycline / Q000009:adverse effects; D010211:Papilledema / Q000139:chemically induced; D011559:Pseudotumor Cerebri / Q000175:diagnosis*; D014794:Visual Fields
D005904:Glial Fibrillary Acidic Protein; D008911:Minocycline