Computed tomography of gliomatosis cerebri

Two cases of gliomatosis cerebri which underwent serial CT-examination with contrast enhancement and histological examination of autopsy material are presented. No one single CT showed all the lesions discovered on neuropathological examination, the lesions in the brainstem, basal ganglia and cerebellum being isodense. The presentation of the lesions on CT was in both cases different. In one case there were several hypodense areas predominantly scattered throughout the white matter of both hemispheres, in the other the main lesion was a "tumor' of the corpus callosum, which lead to the decision for operation. Both cases showed periventricular enhancement expressing the histologically verified periventricular spread of tumor cells. Contrast enhancement appeared in the late stages of the diseases. In the different diagnosis, pseudotumor cerebri, multiple sclerosis, encephalitis and multiple brain metastases are considered. Bearing the possibility of gliomatosis cerebri in mind, CT would help limit the differential diagnosis, especially on the basis of serial CT examinations and in combination with the clinical course.