COVID-19 Ensefaliti İle Karışan Erken Evre Glioblastoma Olgusu
Özet
Glioblastoma(GBM), erişkinlerde en yaygın ve agresif primer beyin tümörü olup genellikle malign bir seyir izler. Bu olgu sunumunda, radyolojik olarak başlangıçta ensefalit ile karıştırılan bir GBM vakası ele alınmıştır. 48 yaşındaki erkek hasta, gribal İnfeksiyon sonrası epileptik nöbetle başvurmuş, manyetik rezonans görüntüleme (MRG) bulguları başta ensefalit olarak değerlendirilmiştir. Ancak, BOS incelemesi ve radyolojik takibin ardından glioblastoma tanısı konmuştur. Bu vaka, GBM'nin özellikle erken dönemde inflamatuar hastalıklarla karıştırılabileceğini ve bu durumun tanı ve tedavi süreçlerinde gecikmelere yol açarak prognozu olumsuz etkileyebileceğini vurgulamaktadır. Özellikle Covid-19 pandemisi bağlamında, viral ensefalit ve GBM gibi hastalıkların ayırıcı tanısının önemine dikkat çekilmektedir.
Glioblastoma(GBM) is the most aggressive and common primary malignant brain tumor in adults. This case report discusses a GBM case that was initially misdiagnosed as encephalitis based on radiological findings. A 48-year-old male presented with an epileptic seizure following a flu-like infection, and the initial MRI findings suggested encephalitis. However, after cerebrospinal fluid (CSF) analysis and further radiological follow-ups, a glioblastoma diagnosis was confirmed. This case highlights that GBM, particularly in its early stages, can mimic inflammatory diseases such as encephalitis, leading to delays in diagnosis and treatment, which can negatively affect prognosis. The report emphasizes the importance of differential diagnosis, especially in the context of the Covid-19 pandemic where viral encephalitis is a consideration.
Referanslar
Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz Sloan JS. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2013-2017. Neuro-Oncology 2020;22(Supplement_1):1-96
Tolgay E, Bahar A, Yurtoğulları Ş, Karlı N, Erer S, Turan F ve ark. Multisentrik Glioblastoma Multiforme Olgusu. Türk Nörol Derg 2008; 14: 272 – 276
(Tamimi AF, Juweid M. Epidemiology and outcome of glioblastoma. In: De Vleeschouwer S, editor. Glioblastoma [Internet]. Brisbane, Australia: Codon Publications; 2017. https://doi.org/10.15586/codon.glioblastoma.2017.ch8.)
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352(10):987–96.
Baehring JM, Bi WL, Bannykh S, Piepmeier JM, Fulbright RK. Diffusion MRI in the early diagnosis of malignant glioma. J Neurooncol 2007;82(2): 221–5.
Granerod J. Cousens S. Davies NW. Crowcroft NS. Thomas SL. New estimates of incidence of encephalitis in England. Emerg Infect Dis. 2013;19:1455–62.
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, Cortese I, Dale RC, Gelfand JM, Geschwind M, Glaser CA, Honnorat J, Höftberger R, Iizuka T, Irani SR, Lancaster E, Leypoldt F, Prüss H, Rae-Grant A, Reindl M, Rosenfeld MR, Rostásy K, Saiz A, Venkatesan A, Vincent A, Wandinger KP, Waters P, Dalmau J. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016 Apr;15(4):391-404. doi: 10.1016/S1474-4422(15)00401-9. Epub 2016 Feb 20. PMID: 26906964; PMCID: PMC5066574.
Vogrig A, Joubert B, Ducray F, Thomas L, Izquierdo C, Decaestecker K, Martinaud O, Gerardin E, Grand S, Honnorat J. Glioblastoma as differential diagnosis of autoimmune encephalitis. J Neurol. 2018 Mar;265(3):669-677. doi: 10.1007/s00415-018-8767-1. Epub 2018 Jan 30. PMID: 29383516.
Batash R, Asna N, Schaffer P, Francis N, Schaffer M (2017). Glioblastoma multiforme, diagnosis and treatment; Recent literature review. Curr Med Chem 2017;24(27):3002-3009
Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K, Hau P, Brandes AA, Gijtenbeek J, Marosi C, Vecht CJ, Mokhtari K, Wesseling P, Villa S, Eisenhauer E, Gorlia T, Weller M, Lacombe D, Cairncross JG, Mirimanoff RO; European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009;10(5):459-466)
Rossi R, Figus A, Corraine S. Early presentation of de novo high grade glioma with epileptic seizures: electroclinical and neuroimaging findings. Seizure 2010;19(8):470–4.
Iacob G, Dinca EB. Current data and strategy in glioblastoma multiforme. J Med Life. 2009 Oct-Dec;2(4):386-93. PMID: 20108752; PMCID: PMC3019011.
Piper K, Foster H, Gabel B, Nabors B, Cobbs C. Glioblastoma Mimicking Viral Encephalitis Responds to Acyclovir: A Case Series and Literature Review. Front Oncol. 2019 Jan 22;9:8. doi: 10.3389/fonc.2019.00008. PMID: 30723703; PMCID: PMC6350341.
Vogrig A, Joubert B, Ducray F, Thomas L, Izquierdo C, Decaestecker K, Martinaud O, Gerardin E, Grand S, Honnorat J. Glioblastoma as differential diagnosis of autoimmune encephalitis. J Neurol. 2018 Mar;265(3):669-677. doi: 10.1007/s00415-018-8767-1. Epub 2018 Jan 30. PMID: 29383516.
Faguer R, Tanguy JY, Rousseau A, Clavreul A, Menei P. Early presentation of primary glioblastoma. Neurochirurgie. 2014 Aug;60(4):188-93. doi: 10.1016/j.neuchi.2014.02.008. Epub 2014 May 21. PMID: 24856049.
Nabizadeh F, Balabandian M, Sodeifian F, Rezaei N, Rostami MR, Naser Moghadasi A. Autoimmune encephalitis associated with COVID-19: A systematic review. Mult Scler Relat Disord. 2022 Jun;62:103795. doi: 10.1016/j.msard.2022.103795. Epub 2022 Apr 6. PMID: 35472834; PMCID: PMC8983076.
Vengalil A, Nizamutdinov D, Su M, Huang JH. Mechanisms of SARS-CoV-2-induced Encephalopathy and Encephalitis in COVID-19 Cases. Neurosci Insights. 2023 May 27;18:26331055231172522. doi: 10.1177/26331055231172522. PMID: 37255742; PMCID: PMC10225804.
Referanslar
Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz Sloan JS. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2013-2017. Neuro-Oncology 2020;22(Supplement_1):1-96
Tolgay E, Bahar A, Yurtoğulları Ş, Karlı N, Erer S, Turan F ve ark. Multisentrik Glioblastoma Multiforme Olgusu. Türk Nörol Derg 2008; 14: 272 – 276
(Tamimi AF, Juweid M. Epidemiology and outcome of glioblastoma. In: De Vleeschouwer S, editor. Glioblastoma [Internet]. Brisbane, Australia: Codon Publications; 2017. https://doi.org/10.15586/codon.glioblastoma.2017.ch8.)
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352(10):987–96.
Baehring JM, Bi WL, Bannykh S, Piepmeier JM, Fulbright RK. Diffusion MRI in the early diagnosis of malignant glioma. J Neurooncol 2007;82(2): 221–5.
Granerod J. Cousens S. Davies NW. Crowcroft NS. Thomas SL. New estimates of incidence of encephalitis in England. Emerg Infect Dis. 2013;19:1455–62.
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, Cortese I, Dale RC, Gelfand JM, Geschwind M, Glaser CA, Honnorat J, Höftberger R, Iizuka T, Irani SR, Lancaster E, Leypoldt F, Prüss H, Rae-Grant A, Reindl M, Rosenfeld MR, Rostásy K, Saiz A, Venkatesan A, Vincent A, Wandinger KP, Waters P, Dalmau J. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016 Apr;15(4):391-404. doi: 10.1016/S1474-4422(15)00401-9. Epub 2016 Feb 20. PMID: 26906964; PMCID: PMC5066574.
Vogrig A, Joubert B, Ducray F, Thomas L, Izquierdo C, Decaestecker K, Martinaud O, Gerardin E, Grand S, Honnorat J. Glioblastoma as differential diagnosis of autoimmune encephalitis. J Neurol. 2018 Mar;265(3):669-677. doi: 10.1007/s00415-018-8767-1. Epub 2018 Jan 30. PMID: 29383516.
Batash R, Asna N, Schaffer P, Francis N, Schaffer M (2017). Glioblastoma multiforme, diagnosis and treatment; Recent literature review. Curr Med Chem 2017;24(27):3002-3009
Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K, Hau P, Brandes AA, Gijtenbeek J, Marosi C, Vecht CJ, Mokhtari K, Wesseling P, Villa S, Eisenhauer E, Gorlia T, Weller M, Lacombe D, Cairncross JG, Mirimanoff RO; European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009;10(5):459-466)
Rossi R, Figus A, Corraine S. Early presentation of de novo high grade glioma with epileptic seizures: electroclinical and neuroimaging findings. Seizure 2010;19(8):470–4.
Iacob G, Dinca EB. Current data and strategy in glioblastoma multiforme. J Med Life. 2009 Oct-Dec;2(4):386-93. PMID: 20108752; PMCID: PMC3019011.
Piper K, Foster H, Gabel B, Nabors B, Cobbs C. Glioblastoma Mimicking Viral Encephalitis Responds to Acyclovir: A Case Series and Literature Review. Front Oncol. 2019 Jan 22;9:8. doi: 10.3389/fonc.2019.00008. PMID: 30723703; PMCID: PMC6350341.
Vogrig A, Joubert B, Ducray F, Thomas L, Izquierdo C, Decaestecker K, Martinaud O, Gerardin E, Grand S, Honnorat J. Glioblastoma as differential diagnosis of autoimmune encephalitis. J Neurol. 2018 Mar;265(3):669-677. doi: 10.1007/s00415-018-8767-1. Epub 2018 Jan 30. PMID: 29383516.
Faguer R, Tanguy JY, Rousseau A, Clavreul A, Menei P. Early presentation of primary glioblastoma. Neurochirurgie. 2014 Aug;60(4):188-93. doi: 10.1016/j.neuchi.2014.02.008. Epub 2014 May 21. PMID: 24856049.
Nabizadeh F, Balabandian M, Sodeifian F, Rezaei N, Rostami MR, Naser Moghadasi A. Autoimmune encephalitis associated with COVID-19: A systematic review. Mult Scler Relat Disord. 2022 Jun;62:103795. doi: 10.1016/j.msard.2022.103795. Epub 2022 Apr 6. PMID: 35472834; PMCID: PMC8983076.
Vengalil A, Nizamutdinov D, Su M, Huang JH. Mechanisms of SARS-CoV-2-induced Encephalopathy and Encephalitis in COVID-19 Cases. Neurosci Insights. 2023 May 27;18:26331055231172522. doi: 10.1177/26331055231172522. PMID: 37255742; PMCID: PMC10225804.
