TY - JOUR
T1 - Progressive multifocal leukoencephalopathy in a patient with glioblastoma
AU - Wu, Jing
AU - Langford, Lauren A.
AU - Schellingerhout, Dawid
AU - Guha-Thakurta, Nandita
AU - Tummala, Sudhakar
AU - Weinberg, Jeffrey S.
AU - Puduvalli, Vinay K.
PY - 2011/7
Y1 - 2011/7
N2 - Malignant gliomas are aggressive malignancies which inevitably recur despite multimodality treatment. In a subset of patients who are longer term survivors of this disease, progressive radiologic worsening can also occur from late effects of radiation rather than recurrent tumor, a differential diagnosis that is commonly considered in this setting. However, other causes for radiologic progression are not as well recognized and could potentially confound management leading to incorrect treatment decisions. Progressive multifocal leukoencephalopathy (PML) is a rare infectious demyelinating disease of the central nervous system seen primarily in immunocompromised patients, the early diagnosis and treatment of which remains a challenge. Here, we report a case of a long term survivor with glioblastoma whose diagnostic and therapeutic management was confounded by the development of PML. We review the radiological features and clinical course of this patient to highlight the dramatic neurological course in the setting of a highly malignant tumor, and emphasize the unusual changes in diffusion weighted images, and the need for clinical suspicion for early diagnosis of PML.
AB - Malignant gliomas are aggressive malignancies which inevitably recur despite multimodality treatment. In a subset of patients who are longer term survivors of this disease, progressive radiologic worsening can also occur from late effects of radiation rather than recurrent tumor, a differential diagnosis that is commonly considered in this setting. However, other causes for radiologic progression are not as well recognized and could potentially confound management leading to incorrect treatment decisions. Progressive multifocal leukoencephalopathy (PML) is a rare infectious demyelinating disease of the central nervous system seen primarily in immunocompromised patients, the early diagnosis and treatment of which remains a challenge. Here, we report a case of a long term survivor with glioblastoma whose diagnostic and therapeutic management was confounded by the development of PML. We review the radiological features and clinical course of this patient to highlight the dramatic neurological course in the setting of a highly malignant tumor, and emphasize the unusual changes in diffusion weighted images, and the need for clinical suspicion for early diagnosis of PML.
KW - Differential diagnosis
KW - Glioblastoma
KW - Immunosuppression
KW - Progressive multifocal leukoencephalopathy
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U2 - 10.1007/s11060-010-0453-9
DO - 10.1007/s11060-010-0453-9
M3 - Article
C2 - 21120583
AN - SCOPUS:79959798840
SN - 0167-594X
VL - 103
SP - 791
EP - 796
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 3
ER -