Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 06, 2015; 84 (14 Supplement) April 22, 2015

Gliomatosis Cerebri Masquerades as a Granulomatous Process (P4.225)

Jamie Labuzetta, Asheen Rama, Brian Lemkuil, Navaz Karanjia
First published April 8, 2015,
Jamie Labuzetta
2UC San Diego Medical Center San Diego CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Asheen Rama
1UC San Diego San Diego CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian Lemkuil
2UC San Diego Medical Center San Diego CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Navaz Karanjia
2UC San Diego Medical Center San Diego CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Citation
Gliomatosis Cerebri Masquerades as a Granulomatous Process (P4.225)
Jamie Labuzetta, Asheen Rama, Brian Lemkuil, Navaz Karanjia
Neurology Apr 2015, 84 (14 Supplement) P4.225;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
0

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Background: Gliomatosis cerebri is a rare primary brain tumor characterized by diffuse neoplastic infiltration generally presenting in the 3rd or 4th decades of life. We present a case of gliomatosis mimicking a granulomatous process. Case: A 38-year-old woman with 6-8 weeks of nonspecific back pain and headache was brought to the hospital after being found unresponsive. Lumbar puncture revealed >1000 RBCs, 45 WBCs, and total protein >1000. MRI brain showed multiple areas of abnormal T2 prolongation and diffuse nodular leptomeningeal enhancement. She had an extensive workup for autoimmune (Anti-Ro/La, ANA, anti-dsDNA, anti-cardiolipin antibodies, RNP, RF), granulomatous (ANCA, ACE), infectious (encephalitis panel, VZV, HIV, Borrelia, Brucella, HTLV, Syphilis, Coccidiomycosis, Entamoeba, Mycobacterium, Cryptococcus, Rickettsia, Toxoplasma), demyelinating (oligoclonal bands, anti-NMO, MBP), toxicological and paraneoplastic (including anti-NMDA) disorders. Three CSF cytology and flow cytometry evaluations were unremarkable, as was CT chest/abdomen/pelvis. Her evaluation was notable for low levels of complement, positive serum JC virus, high CSF albumin, and low CD4 count (225). She was treated empirically with high-dose prednisone, ampicillin, ceftriaxone, and acyclovir, improved to baseline, was discharged home after 15 days, and resumed normal activities (e.g. laundry, cooking), albeit with increased fatigability. Unfortunately, she re-presented less than one week later with decreased oral intake, vomiting, and seizures. CT head revealed acute hydrocephalus. Repeat MRI brain revealed interval worsening of the nodular enhancement “consistent with granulomatous meningitis” and stable intraparenchymal T2 abnormality “suggestive of encephalitis”. MRI spine showed diffuse thoracolumbar nodular thickening and leptomeningeal enhancement. She underwent dural and optico-carotid lesion biopsies. The optico-carotid lesion revealed high-grade astrocytic tumor; she was diagnosed with gliomatosis cerebri. Her family elected to pursue a palliative course. She passed away less than 8 weeks after initial presentation. Conclusions: It is important to consider neoplastic etiologies in the differential of granulomatous processes, even when preliminary neoplastic evaluation is unremarkable.

Disclosure: Dr. LaBuzetta has nothing to disclose. Dr. Rama has nothing to disclose. Dr. Lemkuil has nothing to disclose. Dr. Karanjia has nothing to disclose.

Wednesday, April 22 2015, 7:30 am-12:00 pm

  • Copyright © 2015 by AAN Enterprises, Inc.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within the last 8 weeks.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: 96 (8)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise