Gliomas masks: a series of cases

Abstract

Gliomas are primary brain tumors originating from glial cells. Cases are described when the first symptoms of a  glioma are masked by other pathologies, such as strokes, demyelinating pathologies, encephalitis, or trauma. These are the “masks” of gliomas. The relationship between gliomas and their masks is multilateral and contradictory.
The aim of the research was to analyze cases of divergence from clinical diagnosis to an autopsy when glial tumors were not identified because they were masked by other pathologies.
Material and method: All necropsy records of patients treated in the Institute of Neurology and Neurosurgery from 2017 to 2019 were retrospectively analyzed. 17 cases of divergence were identified and analyzed.
Results: The mean age of the analyzed subjects was 59.1176 ± 14.33 years, they were treated on average 23.8 ± 23.5 days and were hospitalized on average 2.05 ± 1.29 times. Of which 70.6% women and 29.4% men and 41.2% underwent neurosurgery. The clinical picture included cognitive signs (23.5%), headache (41.2%), speech problems (23.5%), bulbar syndrome (35.3%), pain (5.9%), fever (41.2%). History of ischemic stroke - 17.6%. All were scanned but just 41.2% had MRI, only 23.5% suspected tumor. Morpho pathological examination showed that 58.8% were grade IV gliomas and were accompanied by ischemic lesions (11.8%), hemorrhagic (29.8%), and infection (50%) outbreaks.
Conclusion: Retrospective analysis of necropsy results for 2017-2019 demonstrated the presence of a set of patients in whom cerebral gliomas were difficult to identify and were confused with strokes or other diseases. Additional measures are needed to identify atypical cases and to identify masks.