Robert Mc, Wastie Ml
Department of Biomedical Imaging (Radiology), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Biomed Imaging Interv J. 2008 Jan;4(1):e3. doi: 10.2349/biij.4.1.e3. Epub 2008 Jan 1.
Glioblastoma multiforme (GBM) is the most aggressive form of primary brain tumours known collectively as gliomas. Gliomas are graded by their microscopic appearance. As a rule, their behaviour can be predicted from histology: Grade I (pilocytic astrocytomas) and Grade II (benign astrocytomas) tumours are of low grade and grow slowly over many years. Grade IV tumours (GBM) are the most aggressive and, unfortunately, also the most common in humans, growing rapidly, invading and altering brain function. These tumours arise from the supporting glial cells of the brain during childhood and in adulthood.These growths do not spread throughout the body like other forms of cancer, but cause symptoms by invading the brain. Untreated GBMs are rapidly lethal. Most patients with GBM die of their disease in less than a year and none have long term survival.Extracranial metastases from GBM are extremely rare, with a reported frequency of only 0.44% because of the absence of lymphatics in the brain and the difficulty of tumours to penetrate blood vessels. A case of glioblastoma multiforme with the rare features of extensive liver and bone metastases is presented in this paper.
多形性胶质母细胞瘤(GBM)是统称为胶质瘤的原发性脑肿瘤中最具侵袭性的类型。胶质瘤根据其显微镜下的表现进行分级。通常,其行为可从组织学上预测:I级(毛细胞型星形细胞瘤)和II级(良性星形细胞瘤)肿瘤为低级别,多年来生长缓慢。IV级肿瘤(GBM)最具侵袭性,不幸的是,在人类中也最常见,生长迅速,侵袭并改变脑功能。这些肿瘤在儿童期和成年期由大脑的支持性胶质细胞产生。这些肿瘤不像其他形式的癌症那样扩散到全身,而是通过侵袭大脑引起症状。未经治疗的GBM迅速致命。大多数GBM患者在不到一年的时间内死于疾病,无一例长期存活。由于大脑中缺乏淋巴管以及肿瘤穿透血管困难,GBM的颅外转移极为罕见,报告的发生率仅为0.44%。本文介绍了一例具有广泛肝转移和骨转移罕见特征的多形性胶质母细胞瘤病例。