Primary diffuse leptomeningeal gliomatosis mimicking tuberculous meningitis

J Child Neurol. 2014 Dec;29(12):NP171-5. doi: 10.1177/0883073813509121. Epub 2013 Nov 27.

Abstract

Primary diffuse leptomeningeal gliomatosis is a disease with an aggressive course that can result in death. To date, 82 cases have been reported. Here, the case of a 3-year-old male patient presenting with strabismus, headache, and restlessness is reported. Physical examination revealed paralysis of the left abducens nerve, neck stiffness, and bilateral papilledema. Tuberculous meningitis was tentatively diagnosed, and antituberculosis treatment was initiated when cranial imaging revealed contrast enhancement around the basal cistern. Craniocervical magnetic resonance imaging (MRI) was performed when there was no response to treatment, and it revealed diffuse leptomeningeal contrast enhancement around the basilar cistern, in the supratentorial and infratentorial compartments, and in the spinal region. Primary diffuse leptomeningeal gliomatosis was diagnosed by a meningeal biopsy.

Keywords: children; glioma; leptomeningeal gliomatosis; tuberculous meningitis.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Contrast Media
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / diagnosis*
  • Neoplasms, Neuroepithelial / diagnosis*
  • S100 Proteins / metabolism
  • Tuberculosis, Meningeal / physiopathology*

Substances

  • Contrast Media
  • S100 Proteins