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A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease
Published on: April 28, 2019
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Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis
Carla Schettino1,2,3, Ferdinando Caranci4, Giacomo Lus2,3
1Unit of Molecular Neuro-Oncology, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milan, Italy.
Quantitative Imaging in Medicine and Surgery
|November 30, 2017
Summary
Acute hemorrhagic leukoencephalitis can mimic glioblastoma on MRI scans. This case highlights the importance of considering diffuse glioma in differential diagnoses, integrating imaging with pathology for accurate diagnosis.
Area of Science:
- Neurology
- Neuroradiology
- Neuro-oncology
Background:
- Acute disseminated encephalomyelitis (ADEM) and its variants, such as acute hemorrhagic leukoencephalitis (AHLE), are inflammatory demyelinating diseases.
- AHLE can present with diverse neurological symptoms and characteristic MRI findings.
Observation:
- A young man developed sudden diplopia post-respiratory infection.
- Initial MRI suggested AHLE, leading to high-dose dexamethasone treatment, which was discontinued due to intolerance.
- Clinical worsening included gait instability, ataxia, and ophthalmoplegia.
Findings:
- Follow-up MRI revealed severe disease progression with subependymal dissemination.
- Histopathological diagnosis after brain biopsy was glioblastoma.
- This suggests MRI features of AHLE can mask diffuse glioma/glioblastoma.
Implications:
- Diffuse glioma should be considered in the differential diagnosis of atypical AHLE presentations.
- Integrating neuroradiologic findings with neuropathology is crucial for accurate diagnosis.
- This case emphasizes the diagnostic challenges in differentiating inflammatory from neoplastic brain lesions.
