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Imaging patterns of multifocal gliomas

A P Kyritsis1, V A Levin, W K Yung

  • 1Department of Neuro-Oncology, University of Texas, M.D. Anderson Cancer Center, Houston 77030.

European Journal of Radiology
|April 1, 1993
PubMed
Summary
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Multifocal gliomas, presenting as multiple brain masses, are more common than previously thought. Imaging studies reveal various spread patterns, emphasizing the need for thorough evaluation beyond metastatic disease.

Area of Science:

  • Neuro-oncology
  • Radiology
  • Pathology

Background:

  • Cerebral gliomas can present with multiple foci of involvement.
  • Distinguishing true multicentric gliomas from multifocal gliomas with a dissemination route is crucial for diagnosis and treatment.

Purpose of the Study:

  • To review the imaging characteristics of cerebral gliomas with multiple foci.
  • To identify patterns of spread in multifocal gliomas.
  • To emphasize the frequency of multifocal gliomas.

Main Methods:

  • Retrospective review of 51 consecutive cases of cerebral glioma with multiple foci.
  • Analysis of imaging data from MRI and CT scans.
  • Classification of cases based on presence of dissemination route.

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Main Results:

  • Multifocality was present at initial diagnosis in 26 patients and developed later in 25.
  • No clear dissemination route was identified in 14 cases (presumed true multicentric gliomas).
  • The most frequent dissemination routes in multifocal gliomas were meningeal-subarachnoid, subependymal, intraventricular, and direct brain penetration.

Conclusions:

  • Multifocal gliomas are more frequent than commonly recognized.
  • Multiple cerebral masses require thorough evaluation to differentiate from metastatic disease.
  • Understanding dissemination patterns aids in diagnosing and managing multifocal gliomas.