早期仅表现为皮质“飘带征”的胶质母细胞瘤一例

Glioblastoma presenting only as cortical"ribbon sign"in the early stage:a case report

胶质母细胞瘤(glioblastoma,GB)好发于脑白质,是最常见的原发性恶性脑肿瘤。本例GB患者初次就诊头颅磁共振成像(MRI)仅表现为皮质异常信号,诊断为病毒性脑炎。7个月后因记忆力减退、反应迟钝再次入院,MRI提示原病变区出现明显肿块,术后病理证实为GB(世界卫生组织中枢神经系统肿瘤分级为Ⅳ级)。通过分析此病例,考虑部分GB在发病早期时可能仅出现皮质异常信号。因此,如发现皮质异常信号,也应将GB纳入鉴别诊断,结合其他检查综合诊断。

Glioblastoma,which is the most common primary malignant brain tumor,usually occurs in the white matter of the brain.In this case,magnetic resonance imaging(MRI)only showed abnormal cortical signal in the first hospital examination,so he was diagnosed as viral encephalitis.Seven months later,he was admitted to hospital again because of memory loss and slow response.MRI showed obvious mass in the original lesion area.Pathology confirmed glioblastoma(the World Health Organization classification of central nervous system tumors:gradeⅣ).By analyzing this case,it is considered that some glioblastomas may only have cortical lesions in the early stage.Therefore,if cortical abnormal signals are found,glioblastoma should also be included in the differential diagnosis.