Brain Tumor Research and Treatment  2015;3(1):34-38

doi:10.14791/btrt.2015.3.1.34

Primary Diffuse Leptomeningeal Gliosarcomatosis.

Ju Hyung MOON 1 ; Se Hoon KIM ; Eui Hyun KIM ; Seok Gu KANG ; Jong Hee CHANG

Affiliations

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Keywords

Glioma, gliosarcoma; Leptomeningeal carcinomatosis; Meningoencephalitis

Country

Republic of Korea

Language

English

Abstract

Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare condition with a fatal outcome, characterized by diffuse infiltration of the leptomeninges by neoplastic glial cells without evidence of primary tumor in the brain or spinal cord parenchyma. In particular, PDLG histologically diagnosed as gliosarcoma is extremely rare, with only 2 cases reported to date. We report a case of primary diffuse leptomeningeal gliosarcomatosis. A 68-year-old man presented with fever, chilling, headache, and a brief episode of mental deterioration. Initial T1-weighted post-contrast brain magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement without a definite intraparenchymal lesion. Based on clinical and imaging findings, antiviral treatment was initiated. Despite the treatment, the patient's neurologic symptoms and mental status progressively deteriorated and follow-up MRI showed rapid progression of the disease. A meningeal biopsy revealed gliosarcoma and was conclusive for the diagnosis of primary diffuse leptomeningeal gliosarcomatosis. We suggest the inclusion of PDLG in the potential differential diagnosis of patients who present with nonspecific neurologic symptoms in the presence of leptomeningeal involvement on MRI.