Fact-sheet: Brainstem glioma
Updated on 09/04/2020 at 2:20 PM
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Definition
New entity in the 2016 WHO classification.
25% of posterior fossa tumors.
More common tumor in children (7-9 years).
Rarer in adults (30-40 years) and of lower grade (I or II).
Poor prognosis (survival < 10% at 2 years).
Look for histone mutation
Clinical features
Brainstem involvement:
- gait disturbance,
- headache,
- motor deficit,
- diplopia,
- dysphagia,
- nystagmus...
CT
Features:
- Brainstem enlargement
- hypodense
- possible brainstem enhancement
MRI
Features:
- T1: hyposignal
- T2: heterogeneous hypersignal
- Gadolinium-enhanced T1: mild enhancement
- Diffusion: normal
Frequent craniocaudal extension
Management
Radiotherapy, chemotherapy
Less frequently: surgery
Differential diagnosis
Tumors:
- lymphoma, metastasis, germinoma
Infections:
- tuberculosis, listeriosis, Whipple's disease
Inflammatory disease:
- Behçet's disease, ADEM, Sarcoidosis
Vascular disease:
- dural fistula