CASE REPORT: An Indolent Presentation of Gliomatosis Cerebri in an Elderly Patient: Posterior Fossa Decompression Prior to Treatment

Gliomatosis cerebri (GC) is a rare astrocytic tumor that typically affects multiple lobes of the brain. Due to its insidious nature and atypical symptom presentation, diagnosis is often made late in the course of disease process. To date, no definitive treatment guidelines have been established, and due to its infiltrating pattern, neurosurgical resection of the lesion is generally not feasible. We report a case of a 69-year-old male who initially presented with symptoms similar to normal pressure hydrocephalus. The patient underwent CSF diversion, with an inconclusive tissue biopsy. His symptoms were relieved for more than two years thereafter until he demonstrated worsening of symptoms, with a MRI clearly demonstrating GC. Patients presenting with hydrocephalus and a full posterior fossa should be followed carefully for evidence of GC progression.