Table 1 The features of different types of glioma similar to our case
From: Progressive multifocal exophytic pontine glioblastoma: a case report with literature review
Tumor type | Symptoms | Location | Distribution | MRI manifestations | Exophytic growth pattern | Relation to BA | MRS | Pathologic subtypes |
|---|---|---|---|---|---|---|---|---|
DIPG | Triad of cerebellar signs, long tract signs, and CN palsy | Intrinsic, central location in the pons | More than 50%–66% of the pons in axial diameter | Heterogeneous, diffuse, and ring-like enhancement | No | Engulfment of BA | With or without elevated Cho:NAA ratio | Astrocytoma, anaplastic astrocytoma, and glioblastoma (majority) |
Exophytic pontine glioma | Part of the above triad and headache | The pons | Diffuse | Peripheral or ring-like enhancement | Doral, ventral, left, or right side of the cerebellum, CPA (rarely) | Not mentioned | With or without elevated Cho:NAA ratio | Glioblastoma and low-grade glioma |
CPA glioma | CN involvement | The CPA, CN V, and pons | Focal | Irregular or peripheral enhancement | Yes/no | No | With or without elevated Cho:NAA ratio | Glioblastoma, fibrillary astrocytoma, pilocytic astrocytoma, and glioblastoma |
Our case | CN involvement | Multiple lesions involving the CPA and pons | Diffuse | Heterogeneous and ring-like enhancement | Yes | Yes | Progressively increasing Cho:NAA ratio | Glioblastoma |