Primary Focal Intracranial Leptomeningeal Glioma [PFILG]- A case report and review of literature.

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Primary Focal Intracranial Leptomeningeal Glioma [PFILG]- A case report and review of literature.

World Neurosurg. 2018 Apr 21;:

Authors: Narayan V, Savardekar A, Mohammed N, Patra DP, Georgescu MM, Nanda A

Abstract
BACKGROUND: Primary focal intracranial leptomeningeal glioma [PFILG] is considered as a rare solitary glial tumor arising from the leptomeninges without brain attachment or evidence of primary neoplasm elsewhere within the neuraxis. We herein report a case of PFILG in left parietal location with a concise review on its clinico-radiological, histopathological and management characteristics.
CASE PRESENTATION: A 75 year old lady presented with focal motor seizures involving right upper limb with associated occasional headache. MR imaging of the brain revealed a small, focal lesion attached to left parietal dura with underlying brain parenchymal signal changes and contrast enhanced images showed heterogeneous enhancement of tumor as well as meninges. The repeat MRI brain images within a month of primary imaging revealed significant progression of the size of lesion along with invasion of underlying parietal lobe parenchyma. She underwent gross total resection of the lesion and the histo-pathological diagnosis was glioblastoma multiforme [GBM], WHO grade 4, IDH wild type. The patient recovered well from surgery without deficits, however she refused to take adjuvant treatment. The MR brain imaging repeated 3 months after surgery revealed significant progression of the GBM with mass effect. Though adjuvant treatment was then started, she could not tolerate it and succumbed to death after 4 months of surgery.
CONCLUSION: The possibility of high grade PFILG should be considered in any case of an aggressive extra-axial focal lesion. The definitive diagnosis can be made after histological examination. Though surgery followed by adjuvant treatment is considered as the mainstay of treatment, the overall prognostic outcome of high grade PFILG is dismal.

PMID: 29689399 [PubMed - as supplied by publisher]

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