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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The computed tomographic (CT) and magnetic resonance (MR) imaging findings in a middle-aged male with cerebral syphilis are described. He presented with convulsive seizures and focal neurological deficits. A CT scan revealed a slightly enhanced, low-density mass in the left parieto-occipital region. MR imaging showed low intensity on T1-weighted images and high intensity on T2-weighted images. He was initially diagnosed as having a low-grade glioma. However, intraoperative histological examination of a small surgical specimen revealed no tumor cells but heavy infiltration of inflammatory cells in the meninges and cerebral parenchyma. Immunostaining for Treponema organisms by the peroxidase-antiperoxidase method was positive. Although the clinical and radiological findings are nonspecific, neurosyphilis should be considered in any patient in whom a nonspecific mass lesion is demonstrated by CT and MR imaging.
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PMID:Neurosyphilis manifesting as a focal mass lesion: computed tomographic and magnetic resonance imaging features--case report. 169 49

Neurosyphilitic gumma is a slowly progressive inflammatory manifestation of tertiary syphilis. It is characterised by chronic granulomata that ranges from microscopic lesions to large tumour-like masses. While cutaneous, mucosal and skeletal gummatous lesions are not uncommon, neurosyphilitic gumma is rare. F18-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) has been used effectively to assess the metabolic nature of brain masses, in particular in guiding biopsy and grading gliomas. However, the inflammatory nature of lesions such as neurosyphilitic gumma poses challenges to diagnostic imaging modalities including CT scans, MRI and PET. Since FDG is not a specific tracer for malignancy, neurosyphilitic gumma can mimic a high-grade glioma by demonstrating intense FDG uptake and is therefore a potential diagnostic pitfall. We report a case of neurosyphilitic gumma identified on FDG PET.
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PMID:Neurosyphilitic gumma on F18-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography: an old disease investigated with a new technology. 1913 54

We report the case of an HIV-infected man returning from Thailand with secondary syphilis with general symptoms, hepatitis and a pulmonary mass lesion. A cerebrospinal fluid examination showed no signs of neurosyphilis. Two months after successful treatment with benzathine penicillin he presented with a mass lesion in the brain suspected to be a glioma or glioblastoma, which turned out to be a syphilitic gumma. Syphilis remains a great imitator in clinical medicine. Syphilitic brain gummata can develop within a few months.
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PMID:Chameleons everywhere. 2542 29

A 60-year-old man presented with progressive dementia and generalized convulsions. An initial MRI revealed a widespread high-intensity area with a mass effect in the right frontal and temporal lobes on T2-weighted images. Findings on digital subtraction angiography were normal. Serum and CSF tests showed high titers of antibodies to Treponema pallidum, which helped to distinguish neurosyphilis from glioma. He was initially treated with penicillin injection; however, it caused liver dysfunction and penicillin was switched to erythromycin. Even after antibiotic therapy for 2 months, his dementia did not improve. He underwent brain MRI four times during the treatment course, and they showed steady progression of brain atrophy in the right hemisphere. Taking these findings together, we diagnosed Lissauer form of general paresis. To the best of our knowledge, this is the first case of Lissauer form of paretic neurosyphilis, in which the progression of brain atrophy was clearly demonstrated on MRI.
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PMID:[Clinical course and serial brain MRI findings in a patient with Lissauer form of general paresis]. 2590 52