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A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic

Gliomatosis cerebri (GC) is a diffuse infiltrative neoplastic glial process with a devastating prognosis. Considering its rarity, unpredictable clinical manifestations, and lack of characteristic radiographic features, GC is a difficult diagnosis that is quite often delayed. In this report, we prese...

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Autores principales: Prasad, Apoorv, Hurlburt, Gage, Van Antwerp, Emily, Srivastava, Samiksha, Sriwastava, Shitiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319009/
https://www.ncbi.nlm.nih.gov/pubmed/34345333
http://dx.doi.org/10.1016/j.radcr.2021.06.060
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author Prasad, Apoorv
Hurlburt, Gage
Van Antwerp, Emily
Srivastava, Samiksha
Sriwastava, Shitiz
author_facet Prasad, Apoorv
Hurlburt, Gage
Van Antwerp, Emily
Srivastava, Samiksha
Sriwastava, Shitiz
author_sort Prasad, Apoorv
collection PubMed
description Gliomatosis cerebri (GC) is a diffuse infiltrative neoplastic glial process with a devastating prognosis. Considering its rarity, unpredictable clinical manifestations, and lack of characteristic radiographic features, GC is a difficult diagnosis that is quite often delayed. In this report, we present a case of a 61-year-old man with a history of chronic alcohol abuse and atrial fibrillation who presented with right arm weakness initially presumed to be from an acute ischemic stroke. GC was not diagnosed until six months after initial symptoms and diagnosis was indicated when considering the neurocognitive findings in conjunction with suggestive radiographic findings. The presence of a rapid, expansile lesion in the cortex, corpus callosum, and infratentorial structures with mild parenchymal enlargement, as shown in our case, is more revealing of an invasive entity typical of GC rather than an ischemic process and other pathologies. This case demonstrates the fatal challenges of its prompt recognition and the therapeutic limitations for those patients presenting with advanced symptoms at the time of diagnosis. Recognizing GC in cases with such rapid multilobe clinical features with similar diffusely invasive patterns of growth on imaging can avoid a delay in diagnosis and improve patient quality of life.
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spelling pubmed-83190092021-08-02 A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic Prasad, Apoorv Hurlburt, Gage Van Antwerp, Emily Srivastava, Samiksha Sriwastava, Shitiz Radiol Case Rep Case Report Gliomatosis cerebri (GC) is a diffuse infiltrative neoplastic glial process with a devastating prognosis. Considering its rarity, unpredictable clinical manifestations, and lack of characteristic radiographic features, GC is a difficult diagnosis that is quite often delayed. In this report, we present a case of a 61-year-old man with a history of chronic alcohol abuse and atrial fibrillation who presented with right arm weakness initially presumed to be from an acute ischemic stroke. GC was not diagnosed until six months after initial symptoms and diagnosis was indicated when considering the neurocognitive findings in conjunction with suggestive radiographic findings. The presence of a rapid, expansile lesion in the cortex, corpus callosum, and infratentorial structures with mild parenchymal enlargement, as shown in our case, is more revealing of an invasive entity typical of GC rather than an ischemic process and other pathologies. This case demonstrates the fatal challenges of its prompt recognition and the therapeutic limitations for those patients presenting with advanced symptoms at the time of diagnosis. Recognizing GC in cases with such rapid multilobe clinical features with similar diffusely invasive patterns of growth on imaging can avoid a delay in diagnosis and improve patient quality of life. Elsevier 2021-07-15 /pmc/articles/PMC8319009/ /pubmed/34345333 http://dx.doi.org/10.1016/j.radcr.2021.06.060 Text en © 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Prasad, Apoorv
Hurlburt, Gage
Van Antwerp, Emily
Srivastava, Samiksha
Sriwastava, Shitiz
A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title_full A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title_fullStr A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title_full_unstemmed A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title_short A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
title_sort rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8319009/
https://www.ncbi.nlm.nih.gov/pubmed/34345333
http://dx.doi.org/10.1016/j.radcr.2021.06.060
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