Artikel
Infratentorial glioblastoma in adults: Clinical characteristics
Infratentorielles Glioblastom im Erwachsenenalter: Klinische Beobachtungen
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Glioblastoma multiforme is the most common and the most malignant intracranial tumor. Infratentorial location is rare in adults. We present five cases of infratentorial glioblastoma, describing clinical presentation, surgical treatment, tumor histology and post-operative course.
Methods: We retrospectively reviewed all patients who underwent biopsy and/or resection for newly diagnosed glioblastoma (WHO grade IV) between January 1991 and June 2007 at our department. Patients of <21 years were excluded. Clinical characteristics and histopathological features were compared between patients with infratentorial and those with supratentorial tumors.
Results: Within these 16 years, a total of 503 patients underwent surgery for glioblastoma. Among them were 5 individuals with infratentorial tumor location (1%). In detail, tumors were located in the bottom of the fourth ventricle (n=1), in the cerebellum (n=2) and in the brainstem (n=2). The mean age was 55.4 years (Range 27 to 80 years). 3 patients were treated by tumor resection whereas 2 patients underwent Stereotactic biopsy only. After the neurosurgical treatment all patients received radiotherapy.
In the case of a 68-year-old woman with gait disturbance and recurrent drop attacks magnetic resonance imaging revealed a tumor at the bottom of the fourth ventricle without signs of hydrocephalus suspective of ependymoma. Tumor resection was performed via a suboccipital approach. Histological examination revealed glioblastoma. In the case of a 80-year-old male patient with gait disturbance since three months, magnetic resonance imaging showed a 2.5cm diameter tumor in the left cerebellar hemisphere suspective of brain metastasis. Total tumor resection was performed, histological examination revealed glioblastoma.
Conclusions: Infratentorial localisation of glioblastoma in adults is rare and can easily be misdiagnosed as brain metastases or even vestibular schwannoma, ependymoma or meningeoma. Surgical treatment is essential for establishing the diagnosis.