Serial positron emission tomography (PET) in gliomatosis cerebri treated with radiotherapy: a case report
Introduction
Gliomatosis cerebri (GC) is an uncommon neoplastic condition loosely defined as a diffusely infiltrating glioma involving extensive areas of the brain. Diagnosis is difficult because symptoms and signs are variable and nonspecific, and neuroimaging usually does not show a localized mass [1], [2], [3], [4], [5]. Positron emission tomography (PET) in GC has been reported only rarely [6], [7]. We describe the findings of serial PET studies in a patient with biopsy-proven GC.
Section snippets
Case report
A 19-year-old male was admitted to our hospital with a history of abulia and hypersomnia. He had been in low spirits for 2 months and had slept nearly around the clock. Past history and family history were unremarkable. Physical examination on admission showed no abnormalities. Blood pressure was 115/75 mm Hg and heart rate was 70/min with a regular rhythm. He was somnolent, as he reportedly had for the 8 days preceding admission. The pupils were equal, measured 3 mm in diameter, and reacted
Discussion
Gliomatosis cerebri (GC) has a bimodal distribution of occurrence, showing a peak for age at death in the second decade and another peak in the fifth. Mental and behavioral changes (19 of 48 cases in one review), seizures (14 of 48), and headache (14 of 48) are the most commonly reported initial symptoms [1]. The symptoms in our patient, a 19-year-old male in his second decade, also were mental and behavioral: abulia and hypersomnia. The altered mental status and sleep disorder may have
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2012, Handbook of Clinical NeurologyCitation Excerpt :Finally, positron emission tomography (PET) has been evaluated in a few patients with GC. 18F-labeled α-methyltyrosine or [15C]methionine PET may help to differentiate between GC and non-neoplastic differential diagnoses with diffuse T2 hyperintensities (Shintani et al., 2000; Sato et al., 2003) by showing focal hypermetabolism in GC. Future investigations are required to show whether amino acid-based PET may also have prognostic value and/or may be used to monitor therapy.
Gliomatosis cerebri
2005, Textbook of Neuro-Oncology