title: Gliomatosis cerebri diagnostic challenge: two case reports.
abstract: BACKGROUND
  Gliomatosis cerebri is a specific entity defined as a diffuse neoplastic glial cell infiltration of the brain, preserving the architecture of the normal surrounding tissues, involving more than 2 cerebral lobes. Clinical symptoms or radiologic features are nonspecific, and patients are often misdiagnosed with other neurologic diseases.
  
  
  RESULTS
  Here, we report the diagnostic workup of 2 patients with gliomatosis cerebri, discussing the clinical, radiologic, and pathologic findings. Case 1: a 64-year-old woman who presented with an intracranial hypertension syndrome and had symmetrical white matter T2-weighted and fluid-attenuated inversion recovery hyperintensities pattern on magnetic resonance imaging; and case 2: a 54-year-old man with the diagnosis of multiple sclerosis for 8 years who presented with de novo cognitive impairment and focal deficits.
  
  
  CONCLUSIONS
  This report highlights the difficulty of this differential diagnosis and the need of considering it also in the presence of a symmetrical pattern of white matter involvement. Cerebral biopsy remains crucial for the correct diagnosis and treatment approach.
authors: Department of Neurology, Hospital Santo António, Porto, Portugal. ricardotaipa@gmail.com
authors: Ricardo
authors: R
authors: Taipa
authors: Ana Martins
authors: AM
authors: da Silva
authors: Ernestina
authors: E
authors: Santos
authors: Pedro Soares
authors: PS
authors: Pinto
authors: Manuel
authors: M
authors: Melo-Pires
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis*; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000150:complications / Q000175:diagnosis*