Dynamic radiological change of gliomas located in the paralimbic system and its clinical significance.

Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. Methods Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items: initial tumor location, final location and the growth tendency. Results In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. Conclusions Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.