Reactive gliosis misconceived to brain tumor or granuloma

초록

Causes of intracranial mass are various. Although its distinction from tumors or other granuloma is necessary for predicting prognosis and therapeutic planning, accurate diagnosis by MRI or clinical examination is difficult. We report a case of 76-years old patient who underwent removal of large brain mass that caused increased intracranial pressure. MRI showed right-sided large frontal, ipsilateral small frontal and contralateral temporal masses that had low signal in TWI-1, low signal in DWI, high signal in TWI-2 and non-inhancement. The patient was ill with pulmonary tuberculosis. We performed nearly total mass removal for debulking and accurate diagnosis. Histological diagnosis of surgical specimen was reactive gliosis caused by hemorrhagic infarction. This is thought a rare manifestation of reactive gliosis that had acute symptom, continuous bulking, inflammatory reaction and multiple lesions.