Butterfly glioma

Changed by Joshua Yap, 12 Nov 2022

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Disclosures - updated 15 Jul 2022: Nothing to disclose

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Butterfly gliomas are a high grade astrocytomas, ~~usually a~~ ~~glioblastoma~~ (~~WHO grade IV~~)IDH-mutant or glioblastomas, ~~which crosses~~IDH-wildtype that cross the midline via the corpus callosum. Other white matter commissures are also occasionally involved. The term butterfly refers to the symmetric wing-like extensions across the midline.

~~Most~~Butterfly gliomas most frequently ~~butterfly gliomas~~ occur in the frontal lobes, crossing via the genu of the corpus callosum, however posterior ~~butterflies~~butterfly gliomas are also encountered.

Treatment and prognosis

Like all high grade gliomas the prognosis is dismal, and usually no attempt at ~~'curative'~~"curative" resection is made.

Differential diagnosis

primary CNS lymphoma: especially in AIDS patients
cerebral toxoplasmosis: especially in AIDS patients
tumefactive demyelination
cerebral metastases (rare)
occasionally a leptomeningeal process which fills the quadrigeminal and ambient cisterns can cause confusion

-<p><strong>Butterfly gliomas</strong> are a <a href="/articles/diffuse-astrocytoma-grading">high grade astrocytoma</a>, usually a <a href="/articles/glioblastoma">glioblastoma</a> (<a href="/articles/who-classification-of-cns-tumours-1">WHO grade IV</a>), which crosses the midline via the <a href="/articles/corpus-callosum">corpus callosum</a>. Other white matter commissures are also occasionally involved. The term butterfly refers to the symmetric wing-like extensions across the midline. </p><p>Most frequently butterfly gliomas occur in the frontal lobes, crossing via the genu of the corpus callosum, however posterior butterflies are also encountered. </p><h4>Treatment and prognosis</h4><p>Like all high grade gliomas the prognosis is dismal, and usually no attempt at 'curative' resection is made.</p><h4>Differential diagnosis</h4><ul>
~~-<li>~~
~~-<a href="/articles/primary-cns-lymphoma">primary CNS lymphoma</a>: especially in<a href="/articles/hivaids"> AIDS</a> patients </li>~~
~~-<li>~~
~~-<a href="/articles/neurotoxoplasmosis">cerebral toxoplasmosis</a>: especially in <a href="/articles/hivaids">AIDS</a> patients </li>~~
~~-<li><a href="/articles/tumefactive-demyelinating-lesion">tumefactive demyelination</a></li>~~
~~-<li>~~
~~-<a href="/articles/brain-metastases">cerebral metastases</a> (rare)</li>~~
-<li>occasionally a leptomeningeal process which fills the <a href="/articles/quadrigeminal-cistern-1">quadrigeminal</a> and <a href="/articles/ambient-cistern">ambient cisterns</a> can cause confusion</li>
+<p><strong>Butterfly gliomas</strong> are <a href="/articles/diffuse-astrocytoma-grading">high grade</a> <a href="/articles/astrocytoma-idh-mutant-1" title="Astrocytoma, IDH-mutant">astrocytomas, IDH-mutant</a> or <a href="/articles/glioblastoma-idh-wildtype">glioblastomas, IDH-wildtype</a> that cross the midline via the <a href="/articles/corpus-callosum">corpus callosum</a>. Other white matter commissures are also occasionally involved. The term butterfly refers to the symmetric wing-like extensions across the midline. </p><p>Butterfly gliomas most frequently occur in the frontal lobes, crossing via the genu of the corpus callosum, however posterior butterfly gliomas are also encountered. </p><h4>Treatment and prognosis</h4><p>Like all high grade gliomas the prognosis is dismal, and usually no attempt at "curative" resection is made.</p><h4>Differential diagnosis</h4><ul>
+<li><p><a href="/articles/primary-cns-lymphoma">primary CNS lymphoma</a>: especially in<a href="/articles/hivaids"> AIDS</a> patients </p></li>
+<li><p><a href="/articles/neurotoxoplasmosis">cerebral toxoplasmosis</a>: especially in <a href="/articles/hivaids">AIDS</a> patients </p></li>
+<li><p><a href="/articles/tumefactive-demyelinating-lesion">tumefactive demyelination</a></p></li>
+<li><p><a href="/articles/brain-metastases">cerebral metastases</a> (rare)</p></li>
+<li><p>occasionally a leptomeningeal process which fills the <a href="/articles/quadrigeminal-cistern-1">quadrigeminal</a> and <a href="/articles/ambient-cistern">ambient cisterns</a> can cause confusion</p></li>

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