Intratumoral and Peritumoral Brain Abscess Concomitant with Glioblastoma: Report of Two Cases with Review of Literature

Abstract

Intracranial abscess coexistent with a high grade glioma, without prior surgical intervention, is an unusual occurrence. This paper presents two such cases with Nocardia farcinica abscess surrounding the glioblastoma in an immunocompromised individual and Enterococcus faecium abscess within the glioblastoma in an immunocompetent patient. Adjuvant therapy was tapered as per each patient's clinical response. Till date, only eight cases of coexistent high-grade glioma and brain abscess have been reported in literature. This report stands distinct in highlighting the need to radiologically evaluate each foci of a multicentric cranial lesion on its own merit.

Keywords

abscess - glioblastoma - intracranial - intratumoral - Nocardia - peritumoral

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Publication History

Article published online:
25 August 2022

• References

• 1 Noguerado A, Cabanyes J, Vivancos J. et al. Abscess caused by Salmonella enteritidis within a glioblastoma multiforme. J Infect 1987; 15 (01) 61-63
• 2 Asenjo A. Absceso de neumococos operado en adonoma de transition de la hipifisis. Arch Soc Cir Chile 1950; 2: 312-314
• 3 Mohindra S, Gupta R, Mohindra S, Gupta SK, Radotra BD. Posterior-fossa intra-tumoural abscess: a report of three patients and literature review. Br J Neurosurg 2004; 18 (05) 556-560
• 4 Rodriguez RE, Valero V, Watanakunakorn C. Salmonella focal intracranial infections: review of the world literature (1884-1984) and report of an unusual case. Rev Infect Dis 1986; 8 (01) 31-41
• 5 Lo WB, Cahill J, Carey M, Mehta H, Shad A. Infected intracranial meningiomas. World Neurosurg 2014; 81 (3-4): 651.e9-651.e13
• 6 Shankar A, Chacko G, Chacko AG. Intratumoral abscess: an unusual complication of ventriculoperitoneal shunt infection. Childs Nerv Syst 2004; 20 (03) 204-206
• 7 Haimes AB, Zimmerman RD, Morgello S. et al. MR imaging of brain abscesses. AJR Am J Roentgenol 1989; 152 (05) 1073-1085
• 8 Lai PH, Ho JT, Chen WL. et al. Brain abscess and necrotic brain tumor: discrimination with proton MR spectroscopy and diffusion-weighted imaging. AJNR Am J Neuroradiol 2002; 23 (08) 1369-1377
• 9 Campennì A, Caruso G, Barresi V. et al. Gliomas with intratumoral abscess formation: Description of new cases, review of the literature, and the role of (99m)TC-LeukoScan. Kaohsiung J Med Sci 2015; 31 (07) 377-383
• 10 Lee GY, Daniel RT, Brophy BP, Reilly PL. Surgical treatment of nocardial brain abscesses. Neurosurgery 2002; 51 (03) 668-671 , discussion 671–672
• 11 Ichikawa M, Shimizu Y, Sato M. et al. Abscess within a glioblastoma multiforme–case report. Neurol Med Chir (Tokyo) 1992; 32 (11) 829-833
• 12 Sarria JC, Vidal AM, Kimbrough III RC. Salmonella enteritidis brain abscess: case report and review. Clin Neurol Neurosurg 2000; 102 (04) 236-239
• 13 Kalita O, Kala M, Svebisova H. et al. Glioblastoma multiforme with an abscess: case report and literature review. J Neurooncol 2008; 88 (02) 221-225
• 14 Jho DH, Spiliopoulos K, Stein TD, Williams Z. Concomitant presentation of a glioblastoma multiforme with superimposed abscess. World Neurosurg 2011; 75 (01) 126-131 , discussion 50–53
• 15 Tsugu A, Osada T, Nishiyama J, Matsumae M. Glioblastoma associated with intratumoral abscess formation. Case report. Neurol Med Chir (Tokyo) 2012; 52 (02) 99-102
• 16 Singh S, Singh S, Mohammad A, Hussain J. Unusual presentation of brain tumor with intratumoral abscess formation. Arch Int Surg 2013; 3: 66-69
• 17 Kishore K, Beniwal M, Rao S. et al. Abscess within a glioblastoma: mimicking a Matryoshka doll. World Neurosurg 2018; 113: 146-152