Cerebellar giant cell glioblastoma multiforme in an adult

Abstract

Cerebellar glioblastoma multiforme (GBM) is a rare tumor that accounts for only 1% of all cases of GBM and its giant cell variant is even much rarely encountered in adults. A case of cerebellar giant cell GBM managed at our institution reporting its clinical presentation, radiological and histological findings, and treatment instituted is described. In conjunction, a literature review, including particular issues, clinical data, advances in imaging studies, pathological characteristics, treatment options, and the behavior of such malignant tumor is presented. It is very important for the neurosurgeon to make the differential diagnosis between the cerebellar GBM, and other diseases such as metastasis, anaplastic astrocytomas, and cerebellar infarct because their treatment modalities, prognosis, and outcome are different.

Posterior Fossa Glioblastoma, Case Report, and Reviewed Literature

“…The appearance of glioblastoma in the posterior fossa and particularly in the cerebellar parenchyma is a rare occurrence, representing only 1% of all GBM cases. [1,2] As far as we know, only 33 cases of cerebellar glioblastoma in the elderly have been recorded in the literature. [3] This point gives relevance to our report.…”

“…There can be several enhancing lesions, which are either multicentric or multifocal depending on whether there is communication between them. [1,6] Cystic lesions are hypointense while solid lesions are isointense, according to certain investigations on T1-weighted imaging. They appear as heterogeneously hyperintense lesions on T2-weighted imaging.…”

“…Low ADC values on ADC maps and low sig-nals on high b-value DWIs are indicative of the cystic or necrotic components of these tumors. [1] Positron emission tomography/computed tomography (PET/CT) with fluorine-18-fluoro-deoxyglucose (FDG) is sometimes advised and may offer additional alternatives for differential diagnoses when accessible. [5] As in the case of PET/CT, if it is available, the Thallium-201 (Tl) single photon emission computed tomography (SPECT) imaging can be also used in the diagnosis of brain tumors.…”

“…All current forms of treatment have the goal of prolonging survival while maintaining the quality of life. [1,[12][13][14] It is established, for the moment, that surgical resection is the first step toward treatment. However, as previously described, surgery with the objective of total resection is not always feasible.…”

“…Only 1% of cases of GBM in the posterior fossa, and more specifically in the cerebellar parenchyma, are reported. [1,2] Cerebellar glioblastoma in the elderly is uncommon; as far as we know, only 33 cases have been documented in the literature, which lends relevance to our work. [3] A rapidly expanding posterior fossa tumor with increased intracranial pressure and cerebellar symptoms is the most common clinical presentation.…”