A Case With Multicentric Glioblastoma Multiforme

Elif Tolgay; Aslı Bahar; Şükran Yurtoğulları; Necdet Karlı; Sevda Erer; Faruk Turan; Şahsine Tolunay

Elif Tolgay¹, Aslı Bahar¹, Şükran Yurtoğulları¹, Necdet Karlı¹, Sevda Erer¹, Faruk Turan¹, Şahsine Tolunay²

¹Department Of Neurology, Uludag University, Faculty Of Medicine, Bursa, Turkey
²Department Of Pathology, Uludag University, Faculty Of Medicine, Bursa, Turkey

Keywords: glioblastoma multiforme, autopsy

Abstract

Scientific BACKGROUND: Glioblastoma multiforme is the most malign tumor which can be multifocal, including necrosis, vessel proliferation and excessive mitosis, can infiltrate peripherial tissue, and generally located in supratentorial regions.

MR imaging shows a mass lesion with irregular borders and a cavity at the center with non-homogenous contrast enhancement.

CASE: Fifty-three years old patient admitted to our emergency department complaining about seizures and weakness on her left side. On neurologic examination she had a 4/5 MRC muscle strength on her left side with a positive babinski sign and also hemihipoestesia including her face on her left side.

In cranial MRI, it was found that there were lesions with miscellaneous dimensions in right parietal cortex, left thalamus and left cerebellar pedincule without contrast enhancement. Central nervous system (CNS) infection and the primary CNS were the initial diagnoses. All microbiologic indicators were negative both in the serum and liqeur. A stereotactic biopsy was performed and pathology revealed low grade astrocytoma. Her clinical conditioned worsened by time and died due to infections and multiple organ failure.

Pathological autopsy revealed that the mass lesion was glioblastoma multiforme.

CONCLUSION: In this case report we presented a case with a MRI and biopsy suggesting a diagnosis of low grade astrıcytoma. However, clinical findings worsened in a short time causing death of the patient. It is discussed that multifocal GBM can be in different grades on the different parts of the lesions. Although imaging techniques are of utmost importance, in case of discordancy clinical follow-up and neurological examination are still the most important to rely on.