Turkish Neurosurgery 2005 , Vol 15 , Num 1
Are Metachronous Multicentric Gliomas Systemic or Metastatic Disease of the Brain? Case Report and Review of the Literature
İbrahim M. ZİYAL, Özgür İSMAİLOĞLU, Gökhan BOZKURT, Bülent BAKAR, Osman E. ÖZCAN
Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey A 40-year-old male had been operated five years ago due to a right frontal diffuse infiltrative astrocytoma grade II and the tumor had been removed grossly. There was no other lesion in the posterior fossa at that time and the patient received radiotherapy and chemotherapy. Five years later, the patient presented with an infiltrative intraaxial lesion in the left cerebellar hemisphere and vermis and superior to the right cerebellar hemisphere, also compressing the brainstem. After an emergency shunt procedure, the tumor was removed grossly. The histopathological examination revealed a grade III anaplastic astrocytoma. Whether multicentric gliomas (MCG) develop following metastasis with an unknown pathway, or whether they are multifocal and should be considered as a systemic disease of the brain, is open to discussion. We suggest that this pathological condition should be accepted as a systemic disease of the brain. Radiotherapy may induce new tumor foci. The treatment should always be aggressive removal. Keywords : Glioma, multicentric glioma, multiple cerebral lesions, multiple glioma
Corresponding author : Ibrahim M. Ziyal, ibrahimziyal@yahoo.com