Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan; Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.
Neuropathology. 2013 Oct;33(5):576-81. doi: 10.1111/neup.12022. Epub 2013 Feb 13.
Glioblastoma (GBM) is the most common malignant CNS neoplasm, the prognosis of which remains poor even after multidisciplinary treatment. The 5-year overall survival rate of GBM is less than 10% and has remained unchanged for more than 50 years. Because GBM patients rarely survive over a decade, only very few cases of delayed complications caused by therapy have been reported. Here, we report the case of a 24-year-old man who is still alive 21 years after surgical resection and chemoradiotherapy for GBM. This patient developed a cavernous angioma 19 years after the initial surgery as a delayed complication of radiotherapy. The diagnosis of the initial tumor was confirmed by histopathological review, which indicated that the tumor had immunohistochemical and genetic profiles consistent with GBM. Long-term survival in the case of this GBM patient likely resulted from a combination of factors, including hypermethylation of the MGMT (O(6)-methyl guanine methyl transferase) CpG island, young age at diagnosis, good performance status, and complete surgical resection of the tumor. To the best of our knowledge, this case report describes one of the longest-surviving GBM patients and is the first on radiation-induced cavernous angioma in a GBM patient.
胶质母细胞瘤（GBM）是最常见的恶性中枢神经系统肿瘤，即使经过多学科治疗，预后仍然很差。GBM 的 5 年总生存率低于 10%，并且 50 多年来一直没有改变。由于 GBM 患者很少能存活超过十年，因此只有极少数因治疗引起的迟发性并发症的病例报告。在这里，我们报告了一例 GBM 患者的病例，该患者在接受 GBM 的手术切除和放化疗后 21 年仍然存活。该患者在初次手术后 19 年出现海绵状血管瘤，这是放疗的迟发性并发症。初始肿瘤的诊断通过组织病理学回顾得到确认，该肿瘤具有与 GBM 一致的免疫组织化学和遗传特征。该 GBM 患者的长期生存可能是多种因素的综合结果，包括 MGMT（O(6)-甲基鸟嘌呤甲基转移酶）CpG 岛的高甲基化、诊断时年龄较小、良好的表现状态以及肿瘤的完全手术切除。据我们所知，该病例报告描述了存活时间最长的 GBM 患者之一，也是首例 GBM 患者放疗后海绵状血管瘤的病例。
