Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis

Carla Schettino, Ferdinando Caranci, Giacomo Lus, Elisabetta Signoriello, Marica Eoli, Elena Anghileri, Bianca Pollo, Mariarosa A.B. Melone, Giuseppe Di Iorio, Gaetano Finocchiaro, Lorenzo Ugga, Enrico Tedeschi

Research output: Contribution to journalArticle

Abstract

We report the case of a young man with sudden onset of diplopia after an upper respiratory tract infection. Based on the first radiological findings acute hemorrhagic leukoencephalitis, a variant of acute disseminated encephalomyelitis, was suspected and treatment with high dose intravenous dexamethasone was started but it was stopped for intolerance. The patient clinically worsened, developing gait instability, ataxia and ophthalmoplegia; brain MRI performed 20 days later showed severe progression of the disease with subependymal dissemination. After brain biopsy of the right temporal lesion the histological diagnosis was glioblastoma. These findings suggest that MRI features of acute hemorrhagic leukoencephalitis may dissimulate the diagnosis of diffuse glioma/glioblastoma. This case underscores the importance of considering diffuse glioma in the differential diagnosis of atypical signs and symptoms of acute hemorrhagic leukoencephalitis and underlines the relevant role of integrating neuroradiologic findings with neuropathology.

Original languageEnglish
Pages (from-to)592-597
Number of pages6
JournalQuantitative Imaging in Medicine and Surgery
Volume7
Issue number5
DOIs
Publication statusPublished - Oct 1 2017

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Acute Hemorrhagic Leukoencephalitis
Glioblastoma
Glioma
Gait Ataxia
Acute Disseminated Encephalomyelitis
Ophthalmoplegia
Diplopia
Brain
Respiratory Tract Infections
Dexamethasone
Signs and Symptoms
Disease Progression
Differential Diagnosis
Biopsy
Therapeutics

Keywords

  • Acute disseminated encephalomyelitis
  • Acute hemorrhagic encephalitis
  • Diffuse glioma
  • Neurooncology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis. / Schettino, Carla; Caranci, Ferdinando; Lus, Giacomo; Signoriello, Elisabetta; Eoli, Marica; Anghileri, Elena; Pollo, Bianca; Melone, Mariarosa A.B.; Di Iorio, Giuseppe; Finocchiaro, Gaetano; Ugga, Lorenzo; Tedeschi, Enrico.

In: Quantitative Imaging in Medicine and Surgery, Vol. 7, No. 5, 01.10.2017, p. 592-597.

Research output: Contribution to journalArticle

Schettino, C, Caranci, F, Lus, G, Signoriello, E, Eoli, M, Anghileri, E, Pollo, B, Melone, MAB, Di Iorio, G, Finocchiaro, G, Ugga, L & Tedeschi, E 2017, 'Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis', Quantitative Imaging in Medicine and Surgery, vol. 7, no. 5, pp. 592-597. https://doi.org/10.21037/qims.2017.06.09
Schettino, Carla ; Caranci, Ferdinando ; Lus, Giacomo ; Signoriello, Elisabetta ; Eoli, Marica ; Anghileri, Elena ; Pollo, Bianca ; Melone, Mariarosa A.B. ; Di Iorio, Giuseppe ; Finocchiaro, Gaetano ; Ugga, Lorenzo ; Tedeschi, Enrico. / Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis. In: Quantitative Imaging in Medicine and Surgery. 2017 ; Vol. 7, No. 5. pp. 592-597.
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