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Department of Neurosciences (Dr. Chamberlain), University of California, San Diego; and the Departments of Neurological Surgery (Dr. Murovic) and Neuro-Oncology (Dr. Levin), School of Medicine, University of California, San Francisco, CA.
The medical records of 229 consecutive patients with supratentorial malignant gliomas were reviewed with respect to histology, age at diagnosis, tumor location, and enhancement pattern on the CT obtained after the administration of contrast material at the time of operation. Nonenhancing tumors were identified in four (4%) of 93 patients with glioblastoma multiforme (GM), three (30%) of ten with gemistocytic astrocytoma (GA), 23 (31%) of 74 with highly anaplastic astrocytoma (HAA), and 28 (54%) of 52 with moderately anaplastic astrocytoma (MoAA). The age-related incidence of the various glioma histiotypes (both enhancing and nonenhancing) was reflected by the median age at diagnosis: 50 years in GM, 52 years in GA, 40 years in HAA, and 34 years in MoAA. The age and CT contrast enhancement pattern were similar in patients with GM, GA, and MoAA; patients with nonenhancing HAAs tended to be younger at presentation. The tumor location and the frequency of enhancing and nonenhancing lesions were similar for all groups except MoAA, in which nonenhancing tumors were most often frontotemporal and enhancing tumors were usually frontoparietal. Our results demonstrate that it is important to obtain histologic confirmation of the diagnosis in patients with supratentorial gliomas regardless of the presence or absence of contrast enhancement of the tumor on CT, because neither of these characteristics correlates with the tumor histology.
Address correspondence and reprint requests to Dr. Levin, c/o The Editorial Office, Department of Neurological Surgery, 1360 Ninth Avenue, Suite 210, San Francisco, CA 94122.
Supported by grant CA 13525 from the National Institutes of Health.
Dr. Chamberlain was a regular fellow of the American Cancer Society.
Received November 13, 1987. Accepted for publication in final form January 15, 1988.
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