Radiation-induced glioma presenting as diffuse leptomeningeal gliomatosis: a case report.
BACKGROUND
Leptomeningeal gliomatosis is a rare and fatal disease.


METHODS
Case report.


RESULTS
We report the case of a man who was presented with severe intractable headaches, lymphocytic CSF pleocytosis, and spinal leptomeningeal enhancement on contrast MRI. Meningeal biopsy demonstrated diffuse infiltration by malignant glial cells, and symptom alleviation was achieved by CSF diversion. He later developed an enhancing thalamic tumor arising within the treatment field of a remotely irradiated pituitary adenoma. Subsequent management included chemotherapy and further radiotherapy with transient response, before death from leptomeningeal and parenchymal tumor progression 16 months after diagnosis.


CONCLUSIONS
We report a unique case embodying two rare conditions: radiation induced glioma and leptomeningeal gliomatosis. Our patient's course is novel in that symptomatic relief was achieved with CSF diversion and a combination of chemotherapy and focal radiation allowed prolonged survival.
Hill
M D
MD
Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada.
Mackenzie
I
I
Mason
W P
WP
D000236:Adenoma / Q000532:radiotherapy*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002557:Cerebrospinal Fluid Shunts; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005910:Glioma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis* / Q000209:etiology; D010911:Pituitary Neoplasms / Q000532:radiotherapy*
D000970:Antineoplastic Agents