Yampolsky CG, Corti M, Lewi D, Sevlever G; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. B11164.
Muniz Hospital, Buenos Aires, Argentina
BACKGROUND: The primary central nervous system lymphoma (PCNSL) is the principal neoplasm diagnosis to be considered in patients infected with the human immunodeficiency virus type-1 (HIV-1) and focal brain lesions. However, malignant gliomas or other cerebral tumors may often occur in patients with the acquired immunodeficiency syndrome (AIDS) and have been reported in several series. CASE REPORT: A 31 year old woman presented a generalized seizure. She had a history of intravenous drug adiction and a diagnosis of AIDS in 1988. At examination she was alert and did not have any neurological deficit or papilledema. Serology for toxoplasmosis was Ig M negative and Ig G: 1/64. CD 4 count was 42 cells/microlitre. A brain MRI was performed and demonstrated a lesion involving the right frontal lobe and insula. A presumptive diagnosis of TE (toxoplasma encephalitis) was made and antitoxoplasma treatment installed. After a new seizure episode an MRI spectroscopy was performed. The findings suggested a PNCSL and a stereotactic biopsy was performed. Diagnosis was DIFUSE OLIGODENDROGLIOMA TYPE A. 4 months later, a microsurgical resection of the tumor through a pterional craniotomy was achieved. 3 days after surgery she was dismissed. She goes on with HAART therapy and, 32 months after the onset of neurological symptoms, is still in good condition and without neurological deficit. DISCUSSION: Gliomas are a group of tumors arising from their precursors' glia within the CNS. The malignant glioma is the most common primary brain neoplasm, but it is generally not included in the differential diagnosis of lesions of the CNS in patients with AIDS. Oligodendrogliomas probably represent 25% to 33% of all glial tumors. Although PCNSL and toxoplasmosis continue to be the most common intracranial lesions in HIV-infected patients, other pathologic entities should be included in the differential diagnosis of the CNS in patients with AIDS. Up to 1999, only 28 HIV-infected patients with primary brain tumors other than PCNSL have been reported in the literature. Surgical excision is the treatment of choice for these tumors.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Biopsy
- Brain Neoplasms
- Central Nervous System Neoplasms
- Diagnosis, Differential
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Magnetic Resonance Imaging
- Oligodendroglioma
- Toxoplasmosis, Cerebral
- diagnosis
Other ID:
UI: 102276620
From Meeting Abstracts