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Abstract：
Background: Glioblastoma is a malignant brain tumor with poor prognosis requiring early diagnosis. Secondary glioblastoma refers to cases that progressed from low-grade glioma. Evidence shows that timely resection correlates with increased survival. Case presentation: We describe a case of a patient with secondary glioblastoma who was mistakenly diagnosed with Angiostrongylus cantonensis infection until 7 years after disease onset. The patient presented with non-specific clinical manifestations at disease onset. A conventional magnetic resonance imaging (MRI) in the primary survey provided insufficient information, and thus failed to identify the malignancy. During follow-up, unfortunately, clinicians were misled by the patient\'s raw food diet, a positive serum parasite antibody and a result of low glucose metabolism on Fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT). The patient was diagnosed with parasitosis. However, his condition kept getting worse under antiparasitic treatment. Preoperative magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) failed to reverse the mistaken impression. Final diagnosis was confirmed until intraoperative and postoperative pathological findings indicated glioblastoma. Conclusion: We ascribe the incorrect diagnosis to insufficient understanding on imaging manifestations of brain neoplasm as well as clinical features of parasitosis. Thus, we review the MRI, FDG-PET-CT, MRS, and DTI data of this case according to the timeline, refer to relevant studies, and point out the pitfalls. With a long course of slowly progressing, this was a rare case of secondary glioblastoma with the absence of isocitrate dehydrogenase 1 (IDH1) gene mutation.
摘要：
背景：胶质母细胞瘤是一种预后较差的恶性脑肿瘤，需要早期诊断。继发性成胶质细胞瘤是指从低级别神经胶质瘤发展而来的病例。证据表明，及时切除与增加生存率相关。病例介绍：我们描述了一例继发性胶质母细胞瘤患者的病例，该患者被误诊为广州管圆线虫感染，直到疾病发作后7年。患者在疾病发作时呈现非特异性临床表现。初级调查中的常规磁共振成像（MRI）提供的信息不足，因此未能识别恶性肿瘤。随访期间,不幸的是,临床医生被病人的生食饮食误导了，血清寄生虫抗体阳性和氟脱氧葡萄糖-正电子发射断层扫描-计算机断层扫描（FDG-PET-CT）的低葡萄糖代谢结果。患者被诊断为寄生虫病。然而,在抗寄生虫治疗下，他的病情不断恶化。术前磁共振波谱（MRS）和扩散张量成像（DTI）未能逆转错误的印象。最终确诊直至术中、术后病理结果提示胶质母细胞瘤。结论：我们将错误诊断归因于对脑肿瘤的影像学表现以及寄生虫病的临床特征认识不足。因此，我们检查核磁共振,FDG-PET-CT,MRS,根据时间线和这个案例的DTI数据，参考相关研究，并指出陷阱。随着漫长的过程的缓慢发展，这是一例罕见的继发性胶质母细胞瘤,不存在异柠檬酸脱氢酶1(IDH1)基因突变.
