title: Subcutaneous tumor seeding after biopsy in gliomatosis cerebri.
abstract: We observed a patient with subcutaneous seeding from gliomatosis cerebri with a low-grade histopathology. A 33-year-old woman with neurofibromatosis type 1 presented with progressive headache, diplopia, dysphagia, and a rightward instability. On neurological examination dysarthria, gait ataxia, and left-sided central facial and hypoglossal palsies were determined. MRI of the brain demonstrated diffuse, infiltrative non-enhancing lesions in the pons, both cerebellar hemispheres, the parahippocampal gyrus, and the thalamus. A stereotactic biopsy demonstrated an astrocytoma WHO grade 2. These characteristics confirmed gliomatosis cerebri. Three months later, the patient presented with hydrocephalus and a subcutaneous swelling directly underneath the surgical scar. The subcutaneous swelling was removed and the hydrocephalus was treated by ventriculoperitoneal shunting. Histopathological examination confirmed a subcutaneous manifestation of low-grade oligoastrocytoma. Gliomatosis cerebri with low-grade histology can seed subcutaneously.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Buis
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Philip C
authors.initials: PC
authors.lastname: De Witt Hamer
mesh_terms: D000328:Adult; D001706:Biopsy; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D009366:Neoplasm Seeding; D018302:Neoplasms, Neuroepithelial / Q000150:complications / Q000473:pathology / Q000601:surgery*; D009456:Neurofibromatosis 1 / Q000150:complications; D038361:Neuronavigation / Q000009:adverse effects*; D012535:Scalp / Q000473:pathology; D040521:Subcutaneous Tissue / Q000473:pathology*