부산대학교 도서관

Toxoplasma gondii is a parasite that infects more than a third of the world's population. In recent years, some articles have been published showing association between infection with Toxoplasma gondii and brain tumors. We present the case of a male patient, aged 47 years, who was admitted in the Department of Neurosurgery, Emergency Clinical Hospital "Prof. dr. N. Oblu", presenting headache, confusion, blurred vision and loss of memory. His previous medical history revealed that the patient traveled to China, where he ate traditional food based on uncooked meat. During his two months stay in China he presented a status similar to a cold. Craniocerebral magnetic resonance imaging (MRI) took into consideration a primary brain tumor, parasitosis or tuberculoma. Laboratory analysis showed leukocytosis, granulocytosis and thrombocytopenia. Toxoplasma gondii-IgG antibodies showed values of 617.6 U / ml. anti-HIV ELISA test was negative. a biopsy was done and small fragments of pathological tissue were removed. The initial microscopical exam took into consideration a differential diagnosis of atypical toxoplasmic encephalitis versus glioblastoma. Immunohistochemical investigations diagnosed a grade IV glioblastoma based on the following aspects: the tumor cells were positive for GFAP and ATRX, but negative for IDH1. In addition, very often the tumor cells were positive for p53 and proliferative index was greater than 12%. a new MRI exam performed 6 weeks later showed a rapid increase of the tumor, so that the patient was re-operated with total excision of the tumor mass. The final pathologic diagnosis was glioblastoma associated with toxoplasmosis in evolution. The presented case is customized by the difficulty of clinical, imaging and pathological diagnosis under significantly increased titers of Toxoplasma gondii- IgG antibodies. This case also reminds the fact that this parasite may be a potential risk factor for the development of a brain glioblastoma. [ABSTRACT FROM AUTHOR]