Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Background: Radiologic differentiation between a low-grade and high-grade lesion is crucial when deciding extent of resection and prognostication. Occasionally, imaging features can be confusing between the 2 lesions. We report a case that presented such a radiologic dilemma. The lesion appeared benign and extra-axial on routine magnetic resonance imaging sequences. However, subtle clinical and imaging clues pointed to a high-grade lesion.
Case Description: A 27-year-old woman presented with multiple cranial nerve palsies, gait ataxia, and features of increased intracranial pressure. Computed tomography and magnetic resonance imaging showed a petroclival extra-axial contrast-enhancing lesion with areas of chunky calcification. Although choline peak on spectroscopy raised suspicion of a high-grade lesion, the primary differential diagnosis included meningioma and schwannoma considering its characteristic imaging appearance. Postoperative histopathology showed the lesion to be giant cell glioblastoma.
Conclusions: Apart from reporting a rare variant of glioblastoma in an unusual location, this case highlights atypical imaging in a glioblastoma. Brainstem edema may be a subtle indicator of the infiltrative nature of a tumor. Magnetic resonance spectroscopy may be a useful adjunct in such circumstances.
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Source |
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http://dx.doi.org/10.1016/j.wneu.2017.01.043 | DOI Listing |
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