J Korean Neurosurg Soc.  2011 Aug;50(2):119-122. 10.3340/jkns.2011.50.2.119.

Glioblastoma Mimicking Herpes Simplex Encephalitis

• Nam TS
• Choi KH
• Kim MK
• Cho KH

• KMID: 1814117
• DOI: http://doi.org/10.3340/jkns.2011.50.2.119

Abstract

We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

Keyword

Glioblastoma; Herpes simplex encephalitis

MeSH Terms

Aged
Biopsy
Brain
Edema
Encephalitis, Herpes Simplex
Follow-Up Studies
Glioblastoma
Headache
Herpes Simplex
Humans
Leukocytosis
Methylmethacrylates
Polystyrenes
Seizures
Temporal Lobe
Methylmethacrylates
Polystyrenes