title: [A very slow-growing exophytic hemisphere glioma: a case report].
abstract: BACKGROUND
  Gliomas are characterized by a infiltrative pattern of growth, with cellular migration along the white matter fiber tracts, exophytic growth in low-grade gliomas has not been described yet. A case of hemispheric glioma with slow growing and an exophytic component is presented.
  
  
  METHODS
  55 year-old male, with motor partial seizures. MRI shows a WHO grade II oligodendroglioma infiltrating the superior frontal gyrus with exophytic extension above the precentral gyrus. Clinical and radiological follow-up was performed for 23 years. Volumetric assessment of tumor progression revealed a growth rate of 0.5 mm per year. Surgical dissection revealed that the precentral gyrus was displaced inferiorly by the tumor, and a clear subarachnoid plane separated both structures. Functional areas were not identified within the exophytic component. Postoperative neurological deficits were not observed.
  
  
  CONCLUSIONS
  The growth rate in low-grade gliomas has been estimated between 4 and 6 mm per year. The tumor described here had a growth rate of 0.5 mm per year, far below this average. Preoperative identification of this exophytic growth pattern is of major significance for surgical planning. The exophytic tumor is amenable for a safe and complete resection as it is covered by the arachnoid and pial membranes of the cistern and the surrounding brain.
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: Carlos
authors.initials: C
authors.lastname: Velásquez
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: Hugo
authors.initials: H
authors.lastname: Caballero
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: Carlos
authors.initials: C
authors.lastname: Bucheli
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: José
authors.initials: J
authors.lastname: Berciano
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vázquez-Barquero
authors.affiliation: Hospital Universitario Marques de Valdecilla, Santander, Espana.
authors.forename: Juan
authors.initials: J
authors.lastname: Martino
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery; D018450:Disease Progression; D005625:Frontal Lobe; D005910:Glioma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors