Insidiously Coursing Progressive Glioblastoma Multiforme: Case Report

Abstract

Scientific background: Glioblastoma multiforme (GM), being the most common type of primary cerebral tumors, is the most malignant of astrocytic tumors. It constitutes 15-20% of all intracranial tumors and has the worst prognosis. Objective: In this paper, a patient with gllioblastoma multiforme with an insidious course in 2.5 years, whose initial symptoms were overlooked without cognitive evaluation, has been reviewed. Results: A sixty-four year-old female patient was admitted to our department with nausea, vertigo and progressive memory loss. She underwent some investigation for vomiting and vertigo, but did not receive any medication. Neurologic examination revealed mild near and for memory loss and bilateral pyramidal irritation signs. MRI showed a lesion in bilateral hipocampal areas without mass effect, more evident on T2 weighted images. The patient was rehospitalized 8 months later due to gait disturbance and cacosmia. MRI at that time showed a highgrade glial tumor and hydrocephalus. She died 4 months after radiation therapy and palliative surgery. Conclusion: This case emphasizes the importance of cognitive function evaluation in elderly patients with nonspecific symptoms even without long tract signs.