Jung Tae-Young, Jung Shin
Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School, Gwangju, ROK.
Neurol Med Chir (Tokyo). 2007 Sep;47(9):424-7. doi: 10.2176/nmc.47.424.
A 54-year-old man and a 63-year-old woman presented with glioblastoma manifesting as seizure and headache, respectively. Magnetic resonance imaging of the two patients revealed hypointense area on T(1)-weighted imaging, and hyperintense area on T(2)-weighted and diffusion-weighted imaging, with no enhancement after gadolinium administration. Both patients underwent conservative therapy under diagnoses of non-neoplastic cerebral lesion. Six months later, they suffered aggravated symptoms and new neurological deficits. Follow-up magnetic resonance imaging revealed hypointense area on diffusion-weighted imaging and ring enhancement on T(1)-weighted imaging with gadolinium at the site of the previously detected lesions. The tumors showed growth pattern of superficial origin. The large enhanced masses were totally removed through craniotomy under neuronavigator guidance. The histological diagnoses were glioblastoma. Glioblastoma may mimic non-neoplastic conditions on neuroimaging in the early stages. Close follow up of such patients is essential.
一名54岁男性和一名63岁女性分别因表现为癫痫发作和头痛的胶质母细胞瘤前来就诊。两名患者的磁共振成像显示，在T（1）加权成像上为低信号区，在T（2）加权和扩散加权成像上为高信号区，给予钆后无强化。两名患者均在非肿瘤性脑病变的诊断下接受了保守治疗。6个月后，他们出现症状加重和新的神经功能缺损。随访磁共振成像显示，在先前检测到的病变部位，扩散加权成像上为低信号区，T（1）加权成像上钆增强呈环形强化。肿瘤表现为浅表起源的生长模式。在神经导航引导下通过开颅手术将大的强化肿块完全切除。组织学诊断为胶质母细胞瘤。胶质母细胞瘤在早期神经影像学上可能类似非肿瘤性疾病。对此类患者进行密切随访至关重要。
