Romanian Neurosurgery (Dec 2020)
The encephalitic syndrome revealing cerebral gliomatosis in an adolescent
Abstract
Cerebral gliomatosis is a rare glial tumour which is defined by a diffuse and not very destructive infiltration of the encephalon by the glial neoplastic cells in the absence of individualizable tumour mass (Sanson et al., 2005). The clinical and radiological presentation is often misleading and not very specific, and the diagnosis is rarely mentioned. Histological diagnosis remains difficult. Finally, gliomatosis poses a specific therapeutic problem compared to other glial tumours due to the toxicity of panencephalic radiotherapy and the impossibility of achieving surgical reduction of the tumour (Sanson et al., 2005). Data from the literature show a median overall survival of 14.5 months, a higher frequency of oligodendroglial forms. The prognosis is linked to age, functional status, histological grade, oligodendroglial differentiation (Sanson et al., 2005). We report the observation of a gliomatosis occurring in a 14-year-old boy, having presented focal subintral epileptic attacks accompanied by hemiparesis. Flair sequence brain MRI showed a left fronto-temporo-insular hyper signal. The brain biopsy revealed gliomatosis. The evolution was favourable after radiotherapy. Gliomatosis is a diagnosis to be systematically evoked in the presence of a diffuse cerebral affection. Its etiopathogenic mechanism is unknown, and evolution is unpredictable (Millan. BS et al., 2010).
