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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
  1. MRI magnetic resonance imaging, BA basilar artery, MRS magnetic resonance spectroscopy, DIPG diffuse intrinsic pontine glioma, Cho choline, NAA N-acetyl aspartate, CPA cerebellopontine angle, CN cranial nerve