tailieunhanh - báo cáo khoa học: "Isolated angiitis of the central nervous system with tumor-like lesion, mimicking brain malignant glioma: a case report and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Isolated angiitis of the central nervous system with tumor-like lesion, mimicking brain malignant glioma: a case report and review of the literature | You et al. World Journal of Surgical Oncology 2011 9 97 http content 9 1 97 7 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Isolated angiitis of the central nervous system with tumor-like lesion mimicking brain malignant glioma a case report and review of the literature z 1 1 1 2 3 1 Gan You Wei Yan Wei Zhang Shaowu Li Guilin Li and Tao Jiang Abstract Background Isolated angiitis of the central nervous system IACNS is a rare but severe vascular disease which could present like an isolated inflammatory lesion on magnetic resonance imaging MRI . To date only a few such cases with tumor-like IACNS have been reported. Case Presentation A 35-year-old woman presented with headache and left-sided weakness. MRI scans initially mislead us to a diagnosis of glioblastoma GBM . Surgery was performed. The mass was sub-totally resected. Pathological examination confirmed a cerebral vasculitis. Radiological features such as disproportionate mass effect striped hemorrhage and abnormal enhancement of adjacent vessels could be helpful to distinguish a tumor-like IACNS from a GBM. Single therapy with high doses of steroid did not improve the patient s condition. Combined therapy with prednisolone and cyclophosphamide showed great benefit to the patient. No relapse occurred during the period of 18 months follow-up. Conclusions Although a tumor-like IACNS has no established imaging features a diagnosis of tumor-like IACNS should be suspected when MRI shows inappropriate presentations of a tumor. Greater awareness of this potential manifestation of IACNS may facilitate more prompt diagnosis and treatment. Keywords primary angiitis vasculitis tumor-like lesion mimicking glioma Background Isolated angiitis of the central nervous systmen IACNS represents a rare and poorly understood form of vascular inflammatory disease restricted to the brain and spinal cord. An average annual incidence rate of cases per 1 000 000 person-years was found by a report from US 1