Malignant Glioma in the Cerebellum Presenting as MultipleSmall Lesions

Malignant glioma, the most common malignant primary brain tumor in adults, usually occurs in supratentorial space as a singlemass lesion, and cerebellar location and multiple appearance are uncommon. We report a case of a 69-year-old female withthree lesions simultaneously found in the cerebellum on magnetic resonance images (MRIs) after suffering from gaitdisturbance. Two lesions were around 15 mm in size and the other one was observed as a spotty enhancement. Although MRIfindings suggested brain metastases, whole body examinations denied any primary malignancies. Biopsy for one lesion in thecerebellum was performed, which resulted in pathological diagnosis of malignant astrocytoma. The lesions were consideredmulticentric glioma based on MRI definition. The treatment with temozolomide and whole brain radiation was completed.Although the patient was discharged in an independent state with the shrinkage of the tumors, she unexpectedly died followingsudden loss of consciousness from an unknown cause one month after discharge. The coincidence of cerebellar location andmulticentricity characterized by smallness is quite rare in glioma patients, and such MRIfindings might be misleading for thediagnosis. We describe the details of the case and discuss the pathogenesis of this unique presentation of malignant glioma withthe literatures.