A case of primary diffuse leptomeningeal gliomatosis predominantly involving the cervical spinal cord and mimicking chronic meningitis

Turk Neurosurg. 2012;22(1):90-4. doi: 10.5137/1019-5149.JTN.2658-09.1.

Abstract

Gliomas may rarely arise in the leptomeninges without any evidence of intraaxial involvement. A case of primary diffuse leptomeningeal gliomatosis (PDLG) histologically diagnosed as oligoastrocytoma is presented. A 50-year-old woman presented with nausea, vomiting and headache. Magnetic resonance imaging (MRI) of cranium and cervical region revealed dural thickening starting from the craniocervical junction to the level of C4 without any parenchymal lesions. CSF examination showed an increase in protein and decrease in glucose levels. There were neither any kind of atypical cells nor any kind of growth in bacterial cultures. The patient underwent biopsy at the level of C1 for diagnosis. The specimen was diagnosed as primary diffuse leptomeningeal gliomatosis, with phenotypic features of astrocytoma and oligodendroglioma.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae / pathology*
  • Diagnosis, Differential
  • Female
  • Headache / etiology
  • Humans
  • Hydrocephalus / diagnosis
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / therapy
  • Middle Aged
  • Nausea / etiology
  • Neoplasms, Neuroepithelial / diagnosis
  • Neoplasms, Neuroepithelial / pathology*
  • Neoplasms, Neuroepithelial / therapy
  • Paralysis / etiology
  • Spinal Cord Neoplasms / diagnosis
  • Spinal Cord Neoplasms / pathology*
  • Spinal Cord Neoplasms / therapy
  • Tuberculosis, Meningeal / diagnosis*
  • Vomiting / etiology