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Case Reports in Oncological Medicine
Volume 2019, Article ID 6725127, 5 pages
https://doi.org/10.1155/2019/6725127
Case Report

Malignant Glioma in the Cerebellum Presenting as Multiple Small Lesions

1Department of Neurosurgery, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan
2Department of Pathology, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan
3Department of Diagnostic Pathology, School of Medicine Fujita Health University, Toyoake, Aichi, Japan

Correspondence should be addressed to Shinji Shimato; moc.liamg@otamihs.ijnihs

Received 29 August 2018; Revised 26 November 2018; Accepted 4 December 2018; Published 6 January 2019

Academic Editor: Didier Frappaz

Copyright © 2019 Takashi Mamiya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malignant glioma, the most common malignant primary brain tumor in adults, usually occurs in supratentorial space as a single mass lesion, and cerebellar location and multiple appearance are uncommon. We report a case of a 69-year-old female with three lesions simultaneously found in the cerebellum on magnetic resonance images (MRIs) after suffering from gait disturbance. Two lesions were around 15 mm in size and the other one was observed as a spotty enhancement. Although MRI findings suggested brain metastases, whole body examinations denied any primary malignancies. Biopsy for one lesion in the cerebellum was performed, which resulted in pathological diagnosis of malignant astrocytoma. The lesions were considered multicentric glioma based on MRI definition. The treatment with temozolomide and whole brain radiation was completed. Although the patient was discharged in an independent state with the shrinkage of the tumors, she unexpectedly died following sudden loss of consciousness from an unknown cause one month after discharge. The coincidence of cerebellar location and multicentricity characterized by smallness is quite rare in glioma patients, and such MRI findings might be misleading for the diagnosis. We describe the details of the case and discuss the pathogenesis of this unique presentation of malignant glioma with the literatures.