Autopsy Findings in a Long-term Survivor With Glioblastoma Multiforme —Case Report—

Abstract

Autopsy detected no tumor tissues in a patient who died 6.5 years after the diagnosis of glioblastoma multiforme. A 54-year-old male developed left hemiparesis one month prior to admission. Computed tomography demonstrated a cystic lesion in the right frontal region with irregular ring-like enhance ment. The tumor was extensively removed together with the surrounding tissues followed by irradia tion (whole brain 32.4 Gy, local 28.8 Gy), and intravenous administration of interferon-β. Histological examination confirmed the diagnosis of glioblastoma multiforme. He died of accidental head trauma 6.5 years after surgery. Autopsy of the brain detected no evidence of glioblastoma multiforme. The only findings were cerebral edema and hematoma caused by head trauma, as well as histological changes due to radiation damage. This case apparently confirms the histological disappearance of tumor tissue in a long-term survivor with glioblastoma multiforme.

A Case of Long-Term Survival After Glioblastoma, IDH-Wild Type

“…There are several remarkable cases of long-term survivors of glioblastoma reported in the literature (Table 1), 7,8 including a survivor of 34 years postdiagnosis 4 . However, our case represents one of the only reports of a long-term survivor who had a tumor with integrated histomolecular diagnosis of glioblastoma, IDH-wild-type and no residual tumor detected on autopsy 9 …”

“…4 However, our case represents one of the only reports of a long-term survivor who had a tumor with integrated histomolecular diagnosis of glioblastoma, IDHwild-type and no residual tumor detected on autopsy. 9 Our patient's case calls attention to individual, treatment, and tumor-related factors that may contribute to improved survival in glioblastoma (Table 2). She embodied demographic qualities associated with long-term survivorship from glioblastoma: female sex, 17 young age of 48 at diagnosis, 1,4,7-9,17 a high Karnofsky score at diagnosis, 4,7,17 frontal tumor location, 9 and seizures at presentation.…”

“…As molecular testing becomes the standard of care for adult-type diffuse glioma diagnostics, tumor nucleic acid and/or molecular data will more likely become available, allowing for in-depth molecular characterization at the time such patients are identified as longterm glioblastoma survivors. These unique individuals represent an invaluable source that may provide insights into factors associated with prolonged survival and reveal • Lobar tumor location 9 • Tumor calcification 9 • Cyst formation 9 • MGMT hypermethylation 17 • Decreased EGFR amplification 17 • Decreased expression of: CHI3L1, FBLN4, EMP3, IGFBP2, IGFBP3,…”

Life expectancy with glioblastoma at GMC, Bhopal

“…There have been exceptional cases of long-survival spanning 10 years or more, without tumor recurrence, so as to deem those affected 'cured'. The possibility of a complete recovery from glioblastoma was suggested by the Yamada et al case 9 : after dying of skull trauma, an autopsy limited to the brain was performed on a patient who had undergone surgery for a glioblastoma multiforme 6.5 years before; the team carefully searched for the presence of cancer without success, despite collecting numerous histological samples. [10][11][12][13]…”

A very rare case report of long-term survival: A patient operated on in 1994 of glioblastoma multiforme and currently in perfect health

“…There have been exceptional cases [11] , [12] of long-survival spanning 10 years or more, without tumor recurrence, so as to deem those affected ‘cured’. The possibility of a complete recovery from glioblastoma was suggested by the Yamada et al case [13] : after dying of skull trauma, an autopsy limited to the brain was performed on a patient who had undergone surgery for a glioblastoma multiforme 6.5 years before; the team carefully searched for the presence of cancer without success, despite collecting numerous histological samples. There was simply no trace of the tumor.…”