Gliomatosis cerebri (patient information)
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Editor-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.
Overview
Gliomatosis cerebri is a very rare type of tumor affecting the brain. It can affect people of any age from infants to old. This kind of cancer can develop in different parts of the brain, so the symptoms may vary depending on the areas of the brain that are affected. Usual symptoms include headache, hydrocephalus, vomiting, unsteadiness, cognitive problems and symptoms of increased pressure inside skull. Treatments include surgery, radiation therapy, chemotherapy, or a combination of them. Because gliomatosis cerebri may spread in the brain early, the prognosis is not good.
What are the symptoms of Gliomatosis cerebri?
Symptoms can be non specific and mostly represent manifestations of increased intracranial pressure. Some signs and symptoms include:
- Unsteadiness
- Cognitive problems
- Increased pressure inside skull
- Behavioral problems
- Personality changes
- Vision problems
Who is at highest risk?
At present, the risk factors for the development of gliomatosis cerebri are not known.
Diagnosis
- Magnetic resonance imaging (MRI): Head MRI may be the most important test for the diagnosis of gliomatosis cerebri. An MRI uses magnetic fields but which is a different imaging type from computed tomography (CT) to produce detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture. MRI scan takes longer time than CT scan.
- Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose gliomatosis cerebri. It can confirm the location of the cancer and show the site where the cancer might have spread. These are helpful in staging the cancer and in determining whether surgery is a good treatment option. And CT scans can also be used to guide biopsy and a biopsy sample is then removed and looked at under a microscope.
- Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy to accept to produce the images. PET can provide more helpful information than CT scan and MRI scan. It is useful to see if the cancer has spread to lymph nodes and also useful for your doctor to locate where the cancer has spread.
- Chest X-ray: This plain x-ray of your chest may be done to see if the cancer has spread to your lungs.
- Whole Bone Scan: The goal of a whole body bone scan is to show if a cancer has metastasized to your bones.
When to seek urgent medical care?
Call your health care provider if symptoms of gliomatosis cerebri develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
- Severe headache
- Severe vomiting
- Motor dysfunction
Treatment options
The selection of management depends on the stage of the tumor. The options include surgery, radiation therapy, chemotherapy, or a combination of these methods. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.
- Surgery: If cancer stage and general health permitted, surgery can be curative for gliomatosis cerebri. But gliomatosis cerebri is often a fast growing cancer and spreads widely throughout the brain, hence few patients have the chance to receive the surgery. Because of the diffuse characteristic of the lesion, surgery is limited to brain biopsy.
- Radiation therapy: The use of radiation therapy is often difficult because these tumors are radioresistant and the field requiring radiation therapy is large.[1]
- Chemotherapy: Temozolomide and Lomustine-based therapy has been traditionally used. [2]
Diseases with similar symptoms
Where to find medical care for Gliomatosis cerebri?
Directions to Hospitals Treating gliomatosis cerebri
Prevention of Gliomatosis cerebri
Because the risk factors are not clear, the preventive measure is unknown.
What to expect (Outlook/Prognosis)?
The prognosis of gliomatosis cerebriis poor and it depends on the following:
- Whether or not the tumor can be removed by surgery
- The stage of the cancer: the size of the tumor, whether the cancer has spread outside the brain
- The patient’s general health
- Whether the cancer has just been diagnosed or has recurred