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Introduction: gliomatosis cerebri is a diffuse astrocytic neoplasm that involves more than two lobes of the brain. Treatment is not well defined and the prognosis is considered poor., Methods: retrospective analysis of 22 patients with gliomatosis cerebri., Results: we identified 17 men and 5 women (median age 54 years) seen in a Division of Neuro-oncology over a 6 year period. Patients presented with focal sensorimotor or visual deficits (86.4%), seizures (36.4%), cognitive dysfunction (27.3%), or headache (27.3%), suggesting in some cases stroke, migraine, or limbic encephalitis. All patients had bilateral involvement; the regions involved included, temporal (19), basal ganglia (18), frontal (17), parietal (17), corpus callosum (10), and occipital (9). The most frequent pathological findings were grade III astrocytoma (36.4%), grade II astrocytoma (22.7%), and grade IV astrocytoma (18.3%). Nine patients were diagnosed within the first month of symptom development, 11 between the first month and 1 year, and 2 after one year. Seventeen patients received treatment with chemotherapy, radiotherapy or both, and 12 patients (70.6%) had a clinical or radiological response. The median follow-up was 13 months, median progression free survival 6 months, and median survival 9,5 months (15 months if the patients received treatment). Eight patients had thromboembolic events., Conclusions: gliomatosis cerebri has a variable clinical course. Treatment often results in clinical responses. In this study de median survival of patients who received treatment was similar to that reported in series of glioblastoma multiforme., (Published by Elservier España, S.L. All rights reserved.)

Introduction: Gliomatosis cerebri is a rare form of malignant neoplastic glial transformation that involves large areas of the central nervous system., Objective: To describe clinical manifestations, pathognomonic neuroimaging findings and results of radiotherapy of gliomatosis cerebri., Patients and Methods: We review clinical records and neuroimaging studies of two patients with gliomatosis cerebri identified from the files of brain tumor registries of two university hospitals. One patient underwent radiotherapy after surgery., Results: Clinical manifestations and evolution were totally different in both patients despite the fact that both tumors had the same extension on neuroimaging studies. Magnetic resonance imaging revealed the extent of the lesion in both cases, comprising both cerebral hemispheres. Histopathological study revealed G-I and G-II astrocytomas. The patient treated with whole brain irradiation experienced clinical improvement and involution of the brain tumour on neuroimaging studies, and survived 20 months after surgery., Conclusions: Clinical manifestations of gliomatosis cerebri are protean. Therefore, neuroimaging studies and histopathological analysis of brain tissue allow the correct diagnosis. Radiotherapy may improve neurological function in some patients. However, it is necessary to compare the long-term evolution of treated and non-treated patients to evaluate clinical efficacy of radiotherapy.