PURPOSE Cognitive functions are differentially represented in brain hemispheres. Aphasia is an "easy to recognize" symptom of diseases affecting the left side. In contrast, lesions in the right hemisphere cause subtle neuropsychological deficits such as neglect and anosognosia. We evaluated whether right-sided malignant brain tumors are on average larger at the time of first diagnosis as compared to left-sided tumors, and extrapolated the delay in diagnosing right-sided tumors compared to the left side. METHODS All first-ever diagnosed glioblastoma (GBM) patients between 2005 and 2012 were identified using our hospital-based prospective research registry. Baseline data, information on initial clinical presentation and imaging findings (including tumor volume) were collected. Extrapolation of time since tumor initiation was based on an established gompertzian growth model. RESULTS We included 173 patients. Mean age of the study population was 58 ± 13 years. Tumors located in the right hemisphere (n = 96) were larger as compared to tumors located in the left hemisphere (n = 77) (median 36.4 mL [interquartile range 13.0-56.0; minimum 0.2, maximum 140.0] vs. 17.2 mL [7.7-45.1 mL; 0.4, 105.2]; p = 0.011). Right-sided tumors grew longer than left-sided tumors (378 ± 95 days vs. 341 ± 74 days; p = 0.006). Initial neuropsychological symptoms differed depending on the affected hemisphere. CONCLUSION Right-hemispheric symptoms appear to be less clinically conspicuous resulting in a delayed diagnosis of GBM, which might be improved by raising awareness for the corresponding neuropsychological deficits. Whether our findings have prognostic implications needs to be evaluated in future studies.

中文翻译：

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由半球特异性临床表现引起的右侧胶质母细胞瘤患者的诊断延迟。

目的认知功能在脑半球中有差异。失语症是一种影响左侧疾病的“容易识别”症状。相反，右半球的病变会引起细微的神经心理学缺陷，例如忽视和失语症。我们评估了初次诊断时右侧恶性脑肿瘤是否比左侧恶性肿瘤平均更大，并推断出与左侧恶性肿瘤相比，诊断右侧肿瘤的延迟时间更大。方法使用我们基于医院的前瞻性研究注册中心，对2005年至2012年之间所有首次诊断出的胶质母细胞瘤（GBM）患者进行了鉴定。收集基线数据，有关初始临床表现和影像学发现（包括肿瘤体积）的信息。自肿瘤发生以来的时间外推是基于已建立的gompertzian生长模型。结果我们纳入了173例患者。研究人群的平均年龄为58±13岁。与位于左半球的肿瘤（n = 77）相比，位于右半球的肿瘤（n = 96）更大（中位数36.4 mL [四分位间距13.0-56.0；最小0.2，最大140.0]与17.2 mL [7.7] -45.1mL； 0.4，105.2]； p ＝ 0.011）。右侧肿瘤的生长时间长于左侧肿瘤（378±95天vs. 341±74天； p = 0.006）。最初的神经心理学症状因受累的半球而异。结论右半球症状在临床上不太明显，导致GBM的诊断延迟，这可以通过提高对相应神经心理学缺陷的认识来改善。