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• W1983998940 abstract "A right insular lesion was incidentally discovered in a 48-year-old male. Morphological and metabolic radiological characteristics on magnetic resonance imaging (MRI) were in favor of a World Health Organization (WHO) grade II glioma. Despite being advised that surgery was appropriate, the patient elected for conservative management. A second MRI was performed 5 months after, and interpreted as unchanged. A third MRI 4 months later demonstrated a significant increase in tumor size and enhancement in a new distant tumor focus. The patient was referred to our center and underwent surgical resection. Histopathology revealed a grade III astrocytoma. A retrospective quantitative measurement of the radiological growth between the two first MRIs yielded a growth rate of 12 mm/year. This value, highly suggestive of a malignant glioma, shoud have triggered surgery at the time of the second MRI. We conclude that, whenever surgical treatment of a suspected WHO grade II gliomas is postponed, assessing tumor kinetics quantitatively is important to identify patients whose tumor is indeed a WHO grade III glioma. The tumor should be indeed followed by serial MRIs with quantitative measurement of tumor growth, not just “eyeball” qualitative examination. Immediate treatment is indicated in patients with radiological tumor expansion of greater than 8 mm/year. Une lésion insulaire droite a été découverte fortuitement chez un homme de 48 ans. Les caractéristiques radiologiques morphologiques et métaboliques sur l’IRM étaient en faveur d’un gliome de grade II de l’OMS. Bien que la chirurgie lui fut recommandée, le patient choisit une attitude de surveillance proposée dans un autre centre. Une deuxième IRM réalisée cinq mois après fut interprétée comme stable. Une troisième IRM quatre mois plus tard mit en évidence une augmentation de la taille de la lésion et l’apparition d’un nodule de prise de contraste. Le patient fut alors pris en charge et opéré, l’histologie concluant à un astrocytome de grade III. Rétrospectivement, la mesure quantitative de l’évolution entre les deux premières IRM montre un taux de croissance de 12 mm/an. Cette valeur, tout à fait évocatrice d’un gliome de haut grade, aurait dû alerter et inciter à débuter le traitement sans plus de délai. Nous concluons, à partir de ce cas, qu’il est important de suivre l’évolution radiologique d’un probable gliome diffus de bas grade par des mesures quantitatives, et pas seulement une comparaison « de visu ». Le traitement ne devrait être en aucun cas retardé devant un taux de croissance supérieur à 8 mm/an." @default.
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• W1983998940 date "2013-04-01" @default.
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• W1983998940 title "The importance of measuring the velocity of diameter expansion on MRI in upfront management of suspected WHO grade II glioma – Case report" @default.
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• W1983998940 doi "https://doi.org/10.1016/j.neuchi.2013.02.005" @default.
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