[Multiple gliomas. Illustrative cases of 4 different presentations].
Multiple gliomas are uncommon and may be classified according to: a) the time of presentation in early (at diagnosis) or late (during treatment); b) the characteristics of computed tomography or magnetic resonance imaging (CT/MRI) in multifocal (with evidence of spread) and multicentric (without evidence of spread). From 212 patients with histopathologic diagnosis of glioma evaluated from March/90 to September/99, 15 (7%) had multiple lesions. We describe 4 patients: early multicentric, late multicentric, early multifocal and late multifocal, with emphasis on characteristics of CT/MRI and possible differential diagnosis. The differential diagnosis of multiple lesions in the central nervous system includes mainly infectious/inflammatory diseases and metastasis, however multiple gliomas should always be considered, even in patients with known systemic cancer, as described by others. Considering that CT/MRI features are not definite, the diagnosis should always be confirmed by histopathologic examination.
Franco
C M
CM
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP. clelia@unisys.com.br
Malheiros
S M
SM
Nogueira
R G
RG
Batista
M A
MA
Santos
A J
AJ
Abdala
N
N
Stávale
J N
JN
Ferraz
F A
FA
Gabbai
A A
AA
D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000145:classification / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis; D005910:Glioma / Q000145:classification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000145:classification / Q000175:diagnosis*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed