1/33. Isolated oculomotor nerve palsy: an unusual presentation of glioblastoma multiforme. Case report and review of the literature.The authors present a case of a very unusual clinical presentation of an intra-axial supratentorial glioblastoma multiforme (GBM) in a 63 year old diabetic female patient presenting with a three week history of left progressive complete oculomotor nerve palsy. CT scan and magnetic resonance imaging of the head revealed a left intra-axial mesial temporal glioblastoma multiforme. Operative resection and microscopic examination of a tissue specimen confirmed the diagnosis. The nature of the tumor, the pattern of spread and the postulated mechanisms of such a presentation are discussed. The authors suggest including the diagnosis of GBM in the differential diagnosis of patients with isolated complete oculomotor nerve palsy at the appropriate age group.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/33. Congenital glioblastoma diagnosed by fetal sonography.Congenital brain tumors are very rare, and 2-9% of them are accounted for by glioblastomas. We encountered a case of congenital glioblastoma detected at the 39th week of gestation by fetal sonography, which revealed a large echogenic mass in the left temporo-parietal area of the fetal brain with significant midline shift and dilatation of the contralateral lateral ventricle. A detailed sonogram obtained 7 h later showed that the mass had increased in size, and this suggested an expanding hematoma. An emergency cesarean section was performed. Postnatal MRI demonstrated an enhancing mass with a large hematoma. biopsy revealed a malignant brain tumor. Further management was refused and the boy died 6 days after birth. The postmortem pathological diagnosis was glioblastoma. When fetal sonography demonstrates an echogenic mass, a congenital brain tumor should be considered. The mode of delivery should be determined by the nature of the mass and the condition of the fetus.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/33. The analysis of peri-tumor necrosis following the subcutaneous implantation of autologous tumor cells transfected with an episome transcribing an antisense insulin-like growth factor 1 rna in a glioblastoma multiforme subject.A subject inflicted with glioblastoma multiforme who received partial tumor resection and radiotherapy was recruited for an ex vivo gene therapy protocol using irradiated autologous tumor cells that had been engineered to suppress the expression of insulin-like growth factor i as the tumor vaccine. After subcutaneous injection for 8 weeks, the subject developed peri-tumor necrosis with mass effect. The authors wondered whether this event could have resulted from the tumor vaccine. The tissue section bordering the necrotic tumor tissue to the viable normal tissue was examined for nature of any infiltrated cells and their activities. lymphocytes, macrophages, and a small number of neutrophils diffused into the necrotic tumor tissue were found. The infiltrated lymphocytes consisted of both CD4 and CD8 T cells. The functional activity of these lymphocytes was demonstrated by the active production of interferon y and tumor necrosis factor alpha based on the respective immunofluorescent staining localized to these cells. This finding is compatible with the proposed mechanism underlying the tumor vaccination. However, the contribution of radiation treatment to this event cannot be clearly ruled out.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/33. Case history: multicentric glioma with involvement of the optic chiasm.The case is reported of a man, aged 68, with a right-sided temporal glioblastoma multiform and a left sided chiasmal anaplastic glioma, as well as an occipital tumor, presumably of glial nature. The patient had a complete prostatectomy of adenocarcinoma a year before. The coincidence of multicentric gliomas and prostate cancer is briefly discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/33. Conventional MRI, DWI and MR-spectroscopy in the study of focal brain lesions.A case of a patient with neurologic symptoms is reported. Baseline MRI findings were inconclusive to establish a definitive diagnosis. The worsened neurologic and neuroradiologic pattern directed towards a diagnosis of tumor. A second MRI examination and MR-spectroscopy confirmed the hypothesis based on both the diagnosis of nature of the lesion and the histological characterization of the surgical specimen. The technique of MR-spectroscopy is briefly described.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/33. DWI and MR-spectroscopy in the differential diagnosis of focal brain lesions.The case of a patient with a previous history of cerebral infarction, shown to be positive for a brain neoformation on control CT, is presented. Subsequent MRI for an in-depth diagnostic study was completed with DWI and MR spectroscopy to define the nature of the lesion. The differential diagnosis of the lesion is discussed. In conclusion, the major diagnostic role of combined standard MRI with DWI sequences and MR-spectroscopy in the radiologic study of focal brain lesions, is stressed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/33. Sudden, unexpected death due to undiagnosed frontal glioblastoma in a schizophrenic patient.The incidence of sudden death due to undiagnosed primary intracranial tumor is low in forensic autopsy. We report a case of a 48-year-old white male, known to be a schizophrenic patient for several years, and in whom a medico-legal autopsy disclosed a large, previously undiagnosed, bilateral frontal glioblastoma infiltrating the genu of corpus callosum. We emphasize the importance of performing complete autopsy, including a thorough neuropathological examination, in all cases of sudden unexpected death, especially in those cases in which no extracerebral cause of death had been established and whose clinical history was primarily of a psychiatric nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/33. Primary central nervous system lymphoma: role of DWI in the differential diagnosis.The case of a female patient admitted to the hospital for a syncopal episode characterized by mental confusion, retrograde amnesia, agnosia, lack of sphincter control and behavior disorders, is presented. Cranial CT showed a frontal bihemispheric lesion. MRI completed with DWI was then performed to better define the nature of the lesion and for an in-depth diagnostic study. The diagnostic role of conventional MRI combined with DWI and the importance of the latter in the differential diagnosis between primary central nervous system lymphoma (confirmed at histology) and glioblastoma multiforme is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/33. glioblastoma multiforme occurring in a patient following exposure to polychlorinated biphenyls.polychlorinated biphenyls have been shown to be carcinogens in animal studies. Because of lipid solubility and lack of biodegradation, they are known to deposit preferentially in fat and nervous tissue. In this report, we describe a 31-year-old male with prolonged polychlorinated biphenyls exposure who developed glioblastoma multiforme. Fat biopsy documented the presence of markedly elevated PCB levels. A co-worker also developed a malignant astrocytoma. The nature of PCBs and their role in human carcinogenesis are discussed. The possibility of an etiologic link between PCBs and brain tumors should be further investigated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/33. Extracranial metastases of glioblastoma multiforme confirmed by electron microscopy.A case of glioblastoma multiforme which metastasized to the pleura and the lymph nodes of the neck is described. The metastases were detected during the life of the patient. The glial nature of the metastases was confirmed by electronmicriscopic demonstration of typical 90-100 angstrom wide glial fibrils occupying the tumor cell cytoplasm. Electronmicroscopy is recommended to prove the astrocytic nature of a metastatic glioblastoma multiforme. A review of the literature of histologically documented extracranial metastases of glioblastoma multiforme reveals an increase in frequency in recent years. Increased efforts at detection and documentation or an increase in occurrence caused by new methods of treatment are the two possible explanations for this trend.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
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