[Gliomatosis cerebri: clinico-pathological and neuroimaging characteristics and the results of treatment with radiotherapy]. / Gliomatosis cerebri: características clinicopatológicas, de neuroimagen y resultados del tratamiento con radioterapia.

INTRODUCTION: Gliomatosis cerebri is a rare form of malignant neoplastic glial transformation that involves large areas of the central nervous system. OBJECTIVE: To describe clinical manifestations, pathognomonic neuroimaging findings and results of radiotherapy of gliomatosis cerebri. PATIENTS AND METHODS: We review clinical records and neuroimaging studies of two patients with gliomatosis cerebri identified from the files of brain tumor registries of two university hospitals. One patient underwent radiotherapy after surgery. RESULTS: Clinical manifestations and evolution were totally different in both patients despite the fact that both tumors had the same extension on neuroimaging studies. Magnetic resonance imaging revealed the extent of the lesion in both cases, comprising both cerebral hemispheres. Histopathological study revealed G-I and G-II astrocytomas. The patient treated with whole brain irradiation experienced clinical improvement and involution of the brain tumour on neuroimaging studies, and survived 20 months after surgery. CONCLUSIONS: Clinical manifestations of gliomatosis cerebri are protean. Therefore, neuroimaging studies and histopathological analysis of brain tissue allow the correct diagnosis. Radiotherapy may improve neurological function in some patients. However, it is necessary to compare the long-term evolution of treated and non-treated patients to evaluate clinical efficacy of radiotherapy.

[Cystic meningiomas: unusual forms of intracranial neoplasms]. / Meningiomas quísticos: formas inusuales de neoplasias intracraneales.

OBJECTIVE: We report eight patients with cystic intracranial meningiomas to outline the neuroimaging spectrum of this unusual form of intracranial tumors. METHODS: Both CT and MRI were equally effective for the detection of peritumoral or intratumoral cystic lesions. However, neuroimaging findings were nonspecific and did not allow a correct preoperative diagnosis in most cases. CONCLUSIONS: Only a high index of suspicion permits the neurosurgeon a proper recognition of cystic meningiomas and its differentiation from the more common and malignant gliomas.

Neurocysticercosis among patients with cerebral gliomas.

BACKGROUND: Parasites have been implicated in the pathogenesis of human cancer. Anecdotal reports have suggested an association between neurocysticercosis and brain tumors. OBJECTIVE: To determine whether neurocysticercosis is a risk factor for cerebral glioma. DESIGN: Case-control study. SETTING: A university general hospital and a cancer referral center. PATIENTS: Forty-three consecutive patients with a cerebral glioma and 172 controls matched for age, sex, and socioeconomic status. METHODS: We determined the ratio between the frequency of neurocysticercosis in patients with a cerebral glioma and in matched controls. We also evaluated differences in the characteristics of the patients and in the histological type of the neoplasm among case patients with and without neurocysticercosis. In addition, we noted relationships between the location of the cerebral glioma and that of parasitic lesions. RESULTS: Eight (16.8%) of 43 patients with a glioma and 5 (2.9%) of 172 controls had neurocysticercosis (P < .001). The odds ratio for this association was 7.63 (95% confidence interval, 2.03-31.09). Patients with glioma and neurocysticercosis were older than those without neurocysticercosis (mean [+/-SD] age, 62.75 +/- 18.34 years vs 44.69 +/- 14.04 years; P = .02). Glioblastoma multiforme was more frequent among case patients with neurocysticercosis than among those without neurocysticercosis (87.5% vs 48.6%); however, this difference was not statistically significant (P = .24). Six of the 8 patients with neurocysticercosis and a cerebral glioma had calcified parasitic lesions within and around the tumor. CONCLUSIONS: Results from this study suggest that neurocysticercosis is a risk factor for cerebral glioma. The intense astrocytic gliosis that surrounds calcified cysticerci, together with the suppression of the cellular immune response induced by cysticerci, may contribute to the development of malignant glial cells in patients with neurocysticercosis.