{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:16:17Z","timestamp":1788383777210,"version":"build-2803163510"},"reference-count":13,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Cerebral toxoplasmosis is an opportunistic infection that, by itself, is difficult to differentiate from cerebral neoplasms by conventional neuroimaging. It rarely occurs concurrently in patients with a primary brain tumor but when it does, it makes diagnosis and management more difficult. This is a case of a 28-year-old female, diagnosed with a right frontal pleomorphic xanthoastrocytoma with several recurrences, treated with surgery, radiation, and chemotherapy. Three years from diagnosis, the patient was readmitted for generalized body weakness, fever, and a decrease in sensorium. A repeat cranial magnetic resonance imaging showed multiple enhancing lesions in both cerebral hemispheres and in the posterior fossa. Serum toxoplasma IgM and IgG antibody titers were elevated. Single-photon emission computerized tomography (SPECT) with thallium-201 did not show increased tracer uptake in these lesions, favoring toxoplasmosis over tumor recurrence. The patient was treated with trimethoprim-sulfamethoxazole with significant improvement. This is a rare account of cerebral toxoplasmosis arising in the setting of astrocytoma. This is also the first case report to demonstrate the value of thallium-201 SPECT in differentiating central nervous system infection from tumor recurrence, which is pivotal in management. More studies exploring the use of thallium-201 SPECT in distinguishing central nervous system infections from glioma and other malignant tumors should be undertaken to maximize this imaging modality in neuro-oncology practice. <\/jats:p>","DOI":"10.1159\/000529830","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T21:27:03Z","timestamp":1687210023000},"page":"372-377","source":"Crossref","is-referenced-by-count":1,"title":["Differentiating Cerebral Toxoplasmosis and Tumor Recurrence by Thallium-201 Single-Photon Emission Computerized Tomography in a 28-Year-Old Female with Astrocytoma"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2214-6866","authenticated-orcid":false,"given":"Mia Patrice","family":"Dela Vega","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Vincent","family":"Opinaldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julette Marie","family":"Batara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.57.5.848"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.9672"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3347\/kjp.2016.54.2.201"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s002340050569"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-007-0661-5"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.05013-11"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00115-19"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.07.060"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4161\/onci.23288"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/00006231-199907000-00007"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006676"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.22192"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2004.00856.x"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/cro\/article-pdf\/16\/1\/372\/4013118\/000529830.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/cro\/article-pdf\/16\/1\/372\/4013118\/000529830.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:17:36Z","timestamp":1745421456000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000529830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,24]]},"references-count":13,"URL":"https:\/\/doi.org\/10.1159\/000529830","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.23097500","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,24]]}}}