Multifocal and Multicentric Glioblastoma with Leptomeningeal Gliomatosis: A Case Report and Review of the Literature

Abstract

Glioblastoma (GBM) rarely presents as an infratentorial tumor in adults. The authors present a case of concomitant supratentorial and infratentorial GBM in an adult. A 72-year-old man presented with headache, nausea, vomiting, and lightheadedness. Initial MR images revealed enhancing masses in the right cerebellum and right posterior periventricular region. The patient underwent a suboccipital craniotomy and resection of the cerebellar lesion. Final histopathology was consistent with glioblastoma. The patient went on to receive standard radiation treatment for GBM with concurrent and adjuvant temozolomide. However, the patient experienced clinical deterioration within a few days after starting radiotherapy. He and his family decided to forego treatment and pursue palliative care. The patient expired three months after the initial diagnosis. Autopsy findings supported the diagnosis of GBM with leptomeningeal gliomatosis and involvement of the cerebrum, cerebellum, and spinal cord. The authors review the literature and propose that the pathogenesis of multiple and multicentric GBM may involve neural stem cells within the subventricular zone or could result from tumor dissemination along established CNS routes, such as white matter tracts and CSF pathways.

Analysis of the cytotoxicity of hierarchical nanoporous graphenic carbon against human glioblastoma grade IV cells

“…Each sample was measured after 120 s of stabilization at 25°C in three replicates. (5,10,20,50, and 100 μg/mL). Cell morphology was recorded using an optical microscope 24 h after exposure.…”

“…After 45 min of sonification, the stock solution (1.0 mg/mL) was diluted to different concentrations (5,10,20,50, and 100 μg/mL) with fresh 1× DMEM. Each sample was measured after 120 s of stabilization at 25°C in three replicates.…”

“…PrestoBlue™ reagent is quickly reduced by metabolically active cells, providing a quantitative measure of viability and cytotoxicity. U87 cells and fibroblasts were plated in 96-well plates (5×10 3 cells per well) and incubated for 24 h. Then the medium was removed, and samples with the HNC particles were introduced to the cells at increasing concentrations (5,10,20,50, and 100 μg/mL). After 24 h, 10 μL of PrestoBlue™ reagent was added to each well and incubated for an additional 2 h at 37°C.…”

“…U87 cells were plated on opaque-bottomed 96-well plates (3×10 5 cells per well) and incubated for 24 h. Then, the medium was removed, and samples with the HNC particles were introduced to the cells. HNC particles were diluted in fresh DMEM and hydrocolloids were added to cells at increasing concentrations (5,10,20,50, and 100 μg/mL). After 24 h the medium was removed and 100 μL of diluted DCFDA was added to each well and incubated for an additional 45 min at 37°C in the dark.…”

“…3 Despite treatments such as surgical resection, radiotherapy, and chemotherapy, the survival of patients diagnosed with GB is just a few months. 4,5 Therefore, there is a need to implement a future treatment that would involve the use of alternative therapies, such as various carbon nanoparaticles. The nanoparticles of different carbon materials were recently widely investigated because of their in vitro and in vivo biological activity.…”