Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Diffuse infiltrating primary cerebellar glioma involving the brainstem: a case report

Yosuke Nakamura, M.D.1), Norie Ito, M.D.1), Susumu Chiba, M.D.1), Yuuki Ishida, M.D.2), Marie Kato, M.D.3) and Shinya Tanaka, M.D.3)

1) Department of Neurology, Sapporo Nishi-maruyama Hospital
2) Department of Neurosurgery, Nakamura Memorial Hospital
3) Department of Cancer Pathology, Faculty of Medicine, Hokkaido University

An 85-year-old woman was admitted to our hospital with unsteady gait, dizziness, nausea, and vomiting. MRI revealed characteristic abnormal signals in the bilateral cerebellar hemispheres. A brain biopsy was performed which confirmed a definitive histological diagnosis of diffuse glioma. Follow-up MRI showed diffuse abnormal signals that extended from the cerebellum to the brainstem through the cerebellar peduncle without mass formation. Her general condition gradually deteriorated even with the best supportive care, and she died 195 days after admission. Gliomatosis cerebri is characterized by a diffuse infiltrating growth pattern without mass formation in the brain. This case showed a similar proliferation mode from the cerebellum to the brain stem without mass formation. This case was diagnosed based on MRI and pathological findings. Only five similar cases have been previously reported, and compared to these reports, the patient in the present case was the oldest with the poorest prognosis. The histopathological features may influence the appropriate treatment and the prognosis. This disorder is a very rare condition; thus, when we encountered this patient showing cerebellar ataxia with diffuse abnormal MRI signals without mass formation in the cerebellum and brainstem, a brain biopsy was necessary to establish the definitive diagnosis.
Full Text of this Article in Japanese PDF (3509K)

(CLINICA NEUROL, 63: 732－736, 2023)
key words: diffuse glioma, gliomatosis cerebri, cerebellum, brainstem invasion

(Received: 23-Mar-23)