Rare Case Report of Multicentric Glioblastoma Multiforme Initially Mimicking With Herpes Simplex Encephalitis on MRI and Its Progression on Serial Imaging
Bibliographic record
Abstract
We report a case of a 58-year-old man with multicentric glioblastoma initially presenting as acute encephalitic illness. He presented with seizures and cognitive impairment in the emergency department of our hospital. Initially clinical and brain MRI findings were in favor of herpes simplex virus (HSV) encephalitis. The patient had initially improved after medical treatment. After 3 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increase in size of lesions and surrounding perilesional edema in the bilateral frontal lobes, cingulate gyrus and left insular cortex on T2-weighted images and lesions showed enhancement on post-contrast T1-weighted images. Patient underwent right frontal craniotomy and resection of lesion in right frontal region. The treatment is surgery or palliative, and management is controversial. The prognosis, however, remains unfavorable. Therefore, in elderly patients presenting with multifocal lesions on MRI of brain or atypical encephalitic symptoms, the rare possibility of multicentric glioblastoma multiforme should be considered as differential diagnosis. J Med Cases. 2016;7(2):70-76 doi: http://dx.doi.org/10.14740/jmc2401w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".