Diverse imaging features of adolescent glioblastoma: a case report

We highlight an unusual case of multifocal glioblastoma in an adolescent patient, manifesting as four discrete brain lesions, each distinct in appearance. Familiarity with the diverse imaging features of glioblastoma can reduce misdiagnosis and avoid treatment delays.

CRITERIA FOR CHOOSING THE OPTIMAL DELIVERY STRATEGY FOR PATIENTS WITH NERVOUS SYSTEM PATHOLOGY

48 birth histories of patients in the Perinatal center of the V. D. Seredavin SOKB with various diseases of the nervous system were analyzed. 27 patients had planned delivery by caesarean section, due to the combination of relative indications from the fetus and a burdened obstetric history, and 21 – delivery through the natural birth canal. Delivery via the natural birth canal was performed in women with epilepsy-in 28% of patients with neurocirculatory dystonia: - in 16%, with encephalopathy-in 12%, with a herniated disc: - in 12%, with a history of traumatic brain injury-in 12%, with dorsopathy-in 12%, with multiple sclerosis-in 8%, with lumboishalgia-in 4%, with multifocal glioblastoma – 4%. 48% of newborns in women after delivery through the natural birth canal were completely healthy, only 11% had signs of cerebral ischemia, and 19% had slightly pronounced hypoxic and hypotrophic changes. Joint observation of such women during pregnancy by an obstetrician-gynecologist and a neurologist with rational pre-test training allowed to avoid operative delivery.

Multifocal glioblastoma multiform with “encephalitis-like presentation” : a case report

Background Glioblastoma multiform is the most common and aggressive type of primary malignant tumor that affects the central nervous system in adults. It clinically presents with seizures, headache, and/or progressive focal neurological deficits. Radiologically, glioblastoma multiform appears as a single distinguishable, large heterogeneous lesion affecting the cerebrum with characteristic central necrosis, marginal enhancement, and surrounding vasogenic edema. This article describes a patient that exhibited an atypical clinical presentation of multifocal glioblastoma multiform with misleading early radiological features that simulated herpetic encephalitis. Results A 66-year-old female that presented with left-sided hemiparesis and left partial motor seizures underwent multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) scans. A cerebrospinal fluid (CSF) polymerase chain reaction (PCR) test was also performed to screen for herpes simplex virus 1 (HSV-1). Conclusions The early stages of glioblastoma may manifest as symptoms typical to encephalitis, which can delay diagnosis and treatment. Therefore, early diagnosis and identification of atypical glioblastoma multiform presentations, as reported in this article, are essential.

Multifocal glioblastoma—two case reports and literature review

Background Multifocal glioblastoma is a rare type of glioblastoma with worse prognosis. In this article, we aimed to report two cases of classical multifocal glioblastoma. Case presentation In case 1, a 47-year-old male presented with dizziness, and once had a sudden loss of consciousness accompanied by convulsion of limbs. Contrast-enhanced MRI showed multiple lesions with heterogeneously ring-enhanced characters in the left hemisphere, diagnosed as multifocal glioblastoma. He underwent a craniotomy of all lesions, concurrent radiotherapy and chemotherapy as well as additional chemotherapy of temozolomide. After 2 cycles, repeat MRI showed that the new lesions already occurred and progressed. Eventually, he abandoned the chemotherapy after the 2 cycles and died 1 year later. In case 2, a 71-year-old male presented with a history of headache, left limb weakness, and numbness. Discontinuous convulsion of limbs once occurred. Contrast-enhanced MRI showed multiple lesions located in the right hemisphere, diagnosed as multifocal glioblastoma. He underwent a right frontoparietal craniotomy of the main lesion. Hemorrhage of the residual tumor and pulmonary artery embolism occurred synchronously. Eventually, his family decided not to pursue any further treatment and opted for hospice care and he passed away within 11 days of surgery. Conclusions We reported two cases of typical multifocal glioblastoma. Valid diagnosis is crucial; then, resection of multiple lesions and canonical radio-chemotherapy probably bring survival benefits.