Makale Arama

Primary spinal intramedullary glioblastoma is a very rarely seen clinical entity. By this case report main characteristic features and treatment strategies of this rarely seen neoplasm reported and discussed in the light of relevant literature. Fifty years old man admitted to our clinic with numbness and weakness of limbs for a year escpecially worsened last 2 months. Magnetic resonance imaging (MRI) showed expansion of the spinal cord from C3 to C6 by a lesion. The patient operated and tumoral lesion subtotally removed. The pathological results were consistent with glioblastoma multiforme. Main features of this neoplasm discussed with related literature in this report. Despite of the neoplasm’s low incidence it’s rapid progresive clinical course constrain us to make a correct diagnosis immediately to help the individuals.

Glioblastoma multiforme (GBM) is the most malign glial tumor. It rarely causes skin metastasis. It is frequently misdiagnosed as a primary subcutaneous tumor. The number of cases related to skin metastasis of GBM reported in the literature is limited. We here presented a GBM case with scalp invasion and applied with cheloidlike formations on the old craniotomy scar. The patient applied to us with cutaneous, firm, infiltrated nodules in skin color in area concomitant with the incision scar on frontal region. Within 2 months, the nodules turned into a giant tumoral mass covering whole frontal region. The result of the biopsy conducted on nodular lesions were reported as undifferentiated tumor (malign tumor metastasis) scalp. The patient died 3 months after scalp invasion.

Aim: The aim of the present study was to evaluate the general characteristics, survival time and prognostic factors affecting the high grade glial tumor after radiotherapy and chemotherapy. Patients and Methods: Data of 166 patients were retrospectively analyzed. Included histopathologically confirmed cases were grade 3 anaplastic astrocytoma and grade 4 glioblastoma multiforme. Patients were treated with curative radiotherapy and simultaneous ± adjuvant Temozolamide. Results: 73% of the patients were male, 27% were female and the median age was 57 years. 21% were anaplastic astrocytomas, 79% were glioblastom multiforme. 40% of the patients were total, 49% of the patients were subtotally operated and 11% of the patients had only biopsy for diagnostic purposes. The median Karnofski performance score of the patients before radiotherapy was 90. 3-dimensional conformal radiotherapy was applied to 37% of the patients, 63% of the patients were treated with intensity-adjusted radiotherapy technique. Simultaneous Temozolamide was administered with 92% of patients’ radiotherapy. The median follow-up time was 15 months. Overall survival rates were 82 months for anaplastic astrocytoma and 15.5 months for glioblastome multiforme (p <0.001). Overall survival rates at 1, 2, and 5 years were 77%, 59%, and 55% for anaplastic astrocytoma and 59%, 33%, and 4% for glioblastome multiforme, respectively. Median overall survival in patients aged <50 years was 39.3 months, while age ≥50 years was 12.4 months (p <0.001). Overall survival according to operation pattern was 33.2 months in total exposures, 13.8 months in subtotal resections, and 4.9 months in biopsies (p = 0.00). Overall survival was 8.1 months with a performance of <70, while overall survival was 22.3 22.3 months with ≥70 (p = 0.00). Overall survival was 12.9 months in patients who underwent three-dimensional conformal radiotherapy and 21.5 months in patients undergoing intensity-adjusted radiotherapy (p = 0.005). Overall survival was 7.8 months when applied to radiotherapy dose <60 Gy and 21.7 months when given 60 Gy (p = 0.00). Median survival was 18.4 months and 7.2 months, respectively, using concurrent Temozolamide (p = 0.03). Conclusion: In conclusion, the patient’s diagnosis, age, operative form, performance, radiotherapy dose, chemotherapy usage and survival were positive and our results are compatible with the literature.