The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient. The impact of the neurosurgery in elderly patients with glioblastoma multiforme (GBM) is still unclear. The objective of this systematic review was to evaluate the overall survival of patients over 65 years old submitted to GBM surgical treatment and analyze the rates of postoperative complications in this population. A search on the Medline, Cochrane e Google Scholar electronic databases between January 2005 and April 2018 identified seven studies that evaluated the neurosurgical treatment of patients older than 65 years with GBM. Surgical procedures included complete or partial resection or tumor biopsy. In elderly GBM patients, total surgical resection of the tumor was associated with longer overall postoperative survival when compared with the partial resection or biopsy. Based on this study, neurosurgery is recommended to increase the overall survival of elderly patients with GBM and a good overall preoperative condition. The high rate of complications in this population should be taken into consideration for the surgical decision. The details of the methodology of this guideline are set out in Annex I.
RESUMOIntrodução: O glioblastoma multiforme é o tumor primário mais comum do sistema nervoso central. A localização preferencial é supratentorial, sendo considerado rara sua localização na fossa posterior. O exame de ressonância magnética (RM) é fundamental para o diagnóstico diferencial com outras lesões localizadas no ângulo pontocerebelar. O tratamento é cirúrgico associado a radioterapia e quimioterapia. Relato do caso: Paciente de 60 anos de idade com história de cefaleia, diminuição da acuidade auditiva à direita e paralisia facial periférica à direita. Resultado: Ressonância magnética do crânio demonstrou lesão expansiva no ângulo pontocerebelar direito, foi submetido a craniectomia suboccipital direita e exérese total da lesão. Anátomo-patológico resultou em glioblastoma multiforme. Conclusão: O glioblastoma multiforme localizado na fossa posterior apresenta manifestação clínica similar a outras lesões nesta região. O diagnóstico correto é importante para o planejamento terapêutico.ABSTRACT Introduction: Glioblastoma multiforme is the most common primary tumor of the central nervous system. The preferred location is supratentorial, being considered rare its location in the posterior fossa. Magnetic resonance imaging (MRI) is fundamental for differential diagnosis with other lesions located in the cerebellopontine angle. Treatment is surgical and associated with radiotherapy and chemotherapy. Case report: A 60-year-old patient with a history of headache, decreased right auditory acuity and right peripheral facial paralysis. Results: Magnetic resonance imaging of the skull showed an expansive lesion in the right cerebellar angle. Subjected to right suboccipital craniectomy and total lesion excision. Pathological anatomy resulted in glioblastoma multiforme. Conclusion: Glioblastoma multiforme located in the posterior fossa presents clinical manifestation like other lesions in this region. The correct diagnosis is important for therapeutic planning.
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