Cerebellar glioblastoma multiforme in an adult

Abstract

-Cerebellar glioblastoma multiforme (GBM) is a rare tumor. This is the third case published in Brazilian literature and, the last one has been described more than 15 years ago. The aggressive behavior of GBM prompts for fast treatment, which can be hampered by the fact that the diagnosis of GBM re q u i re s a high degree of suspicion. We describe a case of GBM in a 46 years old man. In conjunction, we pre s e n t a literature review including particular issues, clinical data, advances in imaging studies, pathological characteristics, treatment options and the behavior of such malignant tumor.KEY WORDS: high grade astrocytoma, cerebellar glioblastoma multiforme, posterior fossa glioma.Glioblastoma multiforme cerebelar primário em um adulto RESUMO -Glioblastoma multiforme (GBM) c e rebelar é um tumor raro. Apresentamos o terc e i ro caso re v i s ado em literatura neurológica brasileira, sendo o último descrito há mais de 15 anos. Devido a sua agre ssividade, o tratamento deve ser instituído rapidamente, porém certa indefinição quanto à conduta pode o c o rre r, pois o diagnóstico de GBM pode não ser lembrado. Apresentamos um caso de GBM c e rebelar em um homem de 46 anos. Também fazemos uma revisão a respeito de seu comportamento, quadro clínico e avanços quanto à investigação por imagem, aspectos histopatológicos, formas de tratamento e suas características peculiares.PA L AV R A S -C H AVE:a s t rocitoma de alto grau, glioblastoma multiforme cere b e l a r, glioma de fossa posterior.Glioblastoma multiforme (GBM) is the most common primary central nervous system (CNS) tumor in adults comprising approximately 50% of all primary intracranial tumors. Primary cerebellar GBM is a rare tumor in adults 1 -7 and accounts for 1% of all GBM 4 . The reason for its rarity is not completely understood 1 -3 , 5 . D i ff e rential diagnosis of GBM from other CNS lesions is an outstanding issue, especially in re g a rd to its diff e rentiation from other primary CNS tumors such as the anaplasic astrocytoma and from metastases 5 , 7 , 8 since the prognosis and outcome is diff e rent. For this reason, neuroimaging and ultimately the immunostainning assessment are important tools for planning the therapeutic course.We re p o rta case of an adult man with a cere b e llar GBM and a literature review concerning the clinical data, diagnosis including radiological and pathological aspects, treatment and its particular behavior is done. CASEA 46 years old man was admitted due to history of headache beginning 4 months before. Ve n t r i c l e -p e r i t o n e a l shunt was perf o rmed in another hospital due to acute h y d rocephalus 1 month after the initial symptoms. The patient developed progressive cerebellar signs with gait disturbance, nystagmus and clumsiness of the extremities, more intense on the left side, and vomiting. He was unable to walk and showed mild degree of confusional state at examination. A magnetic resonance imaging (MRI) revealed an infiltrative mass situated in the left hemisphere and para-

Cerebellar glioblastoma multiforme: a retrospective study of 28 patients at a single institution

“…However, infratentorial GBM is rare, and it accounts for 0.5%-l% of all intracranial GBM [1,2], only a few individual cases are reported [1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The largest-scale reports to date are a multicenter clinical retrospective study (including 45 patients) and a single-center (including 21 patients) clinical retrospective study [3,12].…”

Primary glioblastoma of the cerebellar vermis: A case report

“…The symptoms of dizziness, mental confusion and neck pain can also be present (9). A diagnosis of cerebellar GBM is not usually pre-operatively suspected, although certain CT and MRI characteristics may indicate it (6,9). Cerebellar metastases, hemangioblastomas, brain abscesses and anaplastic astrocytomas are common differential diagnoses in adults.…”

“…Moreover, the prognosis of patients with glioblastoma is poor, with a 2-year survival rate of 10% and <5% of the patients surviving for a long period of time. The mean survival time for patients with cerebellar glioblastoma after the beginning of symptomatology has been reported to be 12-19 months (6,10).…”

Glioblastoma of the cerebellum and brainstem

“…Furthermore, nausea, vomiting and mental confusion are reported. 6,10,11 Interestingly, compression of the fourth ventricle, resulting in clinically significant hydrocephalus, is not reported in the literature.…”