Imaging patterns of multifocal gliomas

https://doi.org/10.1016/0720-048X(93)90063-SGet rights and content

Abstract

We reviewed the imaging characteristics of 51 consecutive cases of cerebral glioma with multiple foci of involvement. In 26 patients, multifocality was present at the initial diagnosis, whereas in 25, it developed at a later stage. Thirty-two patients were studied with MRI, 13 with CT, and six with both imaging techniques. In 14 cases, no apparent dissemination route was identified; these tumors were presumed to be true multicentric gliomas. In the rest of the cases, various patterns of spread from a primary site were evident or suggested, and the tumors were denoted as multifocal. The most frequent dissemination route in the latter group was the meningeal-subarachnoid space, followed by the subependymal, intraventricular route and direct brain penetration. Multifocal gliomas are more frequent than generally believed and, therefore, multiple cerebral masses should be thoroughly evaluated and not always presumed to be of metastatic origin.

References (13)

There are more references available in the full text version of this article.

Cited by (83)

  • Multifocal and multicentric glioblastoma: Improved characterisation with FLAIR imaging and prognostic implications

    2016, Journal of Clinical Neuroscience
    Citation Excerpt :

    Glioblastoma most commonly presents on imaging as a single peripherally enhancing lesion in an adult patient, although multiple foci of enhancement embedded within a larger region of T2-weighted signal abnormality (multifocal glioblastoma), or even discrete enhancing regions without evidence of connecting tumour (multicentric glioblastoma), are recognised presentations. In such cases, metastatic disease is often considered to be the likely diagnosis, which may delay the diagnosis while efforts are made to determine the primary site of the presumed metastatic disease [1]. As treatment of extracranial malignancy continues to improve, glioblastoma will be seen more commonly in patients with a prior history of cancer, and should remain a diagnostic differential, both to optimise MRI sequences and for appropriate surgical planning.

View all citing articles on Scopus
View full text