[2 cases of multicentric glioma]

Area of Science:

• Neurology
• Oncology
• Pathology

Background:

• Multicentric glioma is a rare primary brain tumor characterized by multiple, simultaneous lesions.
• Distinguishing multicentric glioma from metastatic brain tumors can be challenging clinically and radiologically.

Observation:

• Two patients, a 60-year-old female and a 53-year-old male, presented with multiple, distinct intracranial mass lesions on CT scans.
• Initial clinical suspicion and treatment were based on metastatic brain tumor, involving radiation and chemoimmunotherapy.

Findings:

• Postmortem examinations revealed glioblastoma multiforme in both cases, definitively ruling out metastatic disease.
• Histological analysis showed no tumor cell infiltration along neural pathways or in the cerebrospinal fluid system, supporting a multicentric origin.
• Notably, the first case exhibited distinct histological variations among the different tumor lesions.

Implications:

• These findings highlight the diagnostic challenges in multicentric glioma and underscore the importance of postmortem confirmation.
• The observed histological heterogeneity in one case suggests complex tumor biology that warrants further investigation.
• Understanding the pathogenesis of multicentric glioma is crucial for developing targeted therapies and improving patient outcomes.