Glioblastoma multiforme differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

Glioblastoma multiforme must be differentiated from cerebral metastasis, primary CNS lymphoma, cerebral abscess, anaplastic astrocytoma, tumefactive demyelination, stroke, cerebral toxoplasmosis, radiation necrosis, encephalitis, oligodendroglioma, and seizure disorder.

Differentiating Glioblastoma multiforme from other Diseases

Glioblastoma multiforme must be differentiated from the following:

Differential diagnosis	Characteristic features of the differential diagnosis
Cerebral metastasis	May look identical Both may appear multifocal Metastases are centred on grey-white matter junction and spare the overlying cortex
Primary CNS lymphoma	In patients with AIDS Central necrosis is more common Homogeneously enhancing on MRI
Cerebral abscess	Central restricted diffusion is helpful Hemorrhagic then assessment may be difficult Presence of smooth and complete SWI low intensity rim Presence of dual rim sign
Anaplastic astrocytoma	No central necrosis Absence of hyperplastic blood vessels
Tumefactive demyelination	Can appear similar Open ring pattern of enhancement Younger patients
Stroke	History is suggestive of diagnosis No elevated choline
Cerebral toxoplasmosis	In patients with AIDS
Radiation necrosis	History of radiation exposure
Encephalitis	History of fever Confusion Stiff neck may be present suggestive of meningoencephalitis
Oligodendroglioma	Biopsy helps in differentiation Slower growing tumor Better prognosis
Seizure disorder	Multifactorial Mass may or may not be observed on MRI depending on the cause

References

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