Ontology type: schema:ScholarlyArticle
2022-04-20
AUTHORSAlberto Duran-Peña, François Ducray, Carole Ramirez, Luc Bauchet, Jean Marc Constans, Sylvie Grand, Jean Sébastien Guillamo, Delphine Larrieu-Ciron, Didier Frappaz, Nadya Pyatigorskaya, Julien Savatovsky, Hugues Loiseau, Nadine Martin Duverneuil, Florence Laigle-Donadey
ABSTRACTBackgroundBrainstem gliomas are rare in adults. The diagnosis is often difficult, as some teams still consider brainstem biopsies dangerous and often avoid this procedure. The aim of this study was to describe differential diagnoses that can mimic brainstem glioma, to help clinicians avoid diagnostic and therapeutic mistakes, and to propose a diagnostic algorithm according to radiological presentations.MethodsThe French network of adult brainstem gliomas (GLITRAD) retrospectively collected all reported cases of differential diagnoses between 2006 and 2017. The inclusion criteria were as follows: age over 18 years, lesion epicenter in the brainstem, radiological pattern suggestive of a glioma and diagnostic confirmation (histopathological or not, depending on the disease).ResultsWe identified a total of 68 cases. Most cases (58/68, 85%) presented as contrast-enhancing lesions. The most frequent final diagnosis in this group was metastases in 24/58 (41%), followed by central nervous system lymphoma in 8/58 (14%). Conversely, MRI findings revealed 10/68 nonenhancing lesions. The most frequent diagnosis in this group was demyelinating disease (3/10, 30%).ConclusionThe risk of diagnostic mistakes illustrates the need to consider the more systematic use of a brainstem biopsy when reasonably possible. However, we propose an MRI-based approach to the differential diagnosis of gliomas to limit the risk of misdiagnosis in cases where a biopsy is not a reasonable option. More... »
PAGES1-14
http://scigraph.springernature.com/pub.10.1007/s00415-022-11070-6
DOIhttp://dx.doi.org/10.1007/s00415-022-11070-6
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/35441889
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