Four epileptic patients with low-grade gliomas were followed with computed tomography (CT) from the onset of epilepsy. In each case, focal epilepsy was the initial symptom. All four patients had left frontal lobe lesions, which manifested on CT scans as low-density areas (three patients) and calcifica tion (one patient) without mass effect. In each case, little change was evidenced by follow-up CT scans obtained over a considerable period of time, and then tumor growth was noted, as indicated

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... the ap pearance of mass effect and/or contrast enhancement on CT scans. These findings underscore the necessity of following patients whose CT scans demonstrate low-density areas or calcification without mass effect for more than 2 years. In addition, when the diagnosis is uncertain, early biopsy and histological confirmation of gliomas should significantly improve the prognosis for these patients.