Gliomatosis cerebri: Clinico-pathological and neuroimaging characteristics, and the results of treatment with radiotherapy

Introduction. Gliomatosis cerebri is a rare form of malignant neoplasic glial transformation that involves large areas of the central nervous system. Objective. To describe clinical manifestations, patognomonic neuroimaging findings and results of radiotherapy of gliomatosis cerebri. Patients and methods. We review clinical records and neuroimaging studies of two patients with gliomatosis cerebri identified from the files of brain tumor registries of two university hospitals. One patient underwent radiotherapy after surgery. Results. Clinical manifestations and evolution were totally different in both patients despite the fact that both tumors had the same extension on neuroimaging studies. Magnetic resonance imaging revealed the extent of the lesion in both cases, comprising both cerebral hemispheres. Histopathological study revealed G-I and G-II astrocytomas. The patient treated with whole brain irradiation experienced clinical improvement and involution of the brain tumour on neuroimaging studies, and survived 20 months after surgery. Conclusions. Clinical manifestations of gliomatosis cerebri are protean. Therefore, neuroimaging studies and histopathological analysis of brain tissue allow the correct diagnosis. Radiotherapy may improve neurological function in some patients. However, it is necessary to compare the long-term evolution of treated and non-treated patients to evaluate clinical efficacy of radiotherapy.