Hg-33multifocal Glioblastoma: a Pediatric Case and Literature Review
Year: 2016
Type: article
Abstract: INTRODUCTION: Multifocal glioblastoma is rare with an extremely poor prognosis. Multifocal GBM is thought to arise from the spread of the tumor via a connecting pathway. Because of this spread, complete resection is generally unfeasible, especially if it involves deep brain structures. Few cases have been reported in pediatric patients; here we present a pediatric case and literature review. CASE PRESENTATION: A 14 year old girl presented to our institution following several weeks of headache, vertigo, nausea, and visual blurriness. Cranial MRI revealed a large expansile mass causing mass effect centered in her right thalamus with involvement of her right basal ganglia, medial right temporal lobe, and hippocampus with additional foci in the left corpus callosum, hypothalamus, and lateral cerebellum. Initial pathology following endoscopic biopsy showed a WHO grade 3 anaplastic astrocytoma. Two treatment options were considered: primary chemoradiotherapy or surgery with adjuvant chemoradiotherapy. The survival benefit of the surgical approach in multifocal disease is unclear; however, primary radiotherapy has the risk of swelling leading to decreased quality of life. Because she was already experiencing progressive symptoms due to mass effect, she underwent subtotal resection rather than primary radiation. Pathology at that time showed small amounts of necrosis making her lesion a grade IV tumor. She then proceeded to adjuvant chemoradiotherapy but had progressive and ultimately fatal disease despite subsequent palliative resections. CONCLUSION: Multifocal glioblastoma is a rare brain tumor in children with inadequate treatment options. We present a case and literature review of this entity.
Source: Neuro-Oncology
Institution: University of Wisconsin–Madison
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4249612563