Singh Gajendra, Mehrotra Anant, Sardhara Jayesh, Das Kuntal K, Jamdar Janmejay, Pal Lily, Srivastava Arun K, Sahu Rabi N, Jaiswal Awadhesh K, Behari Sanjay
Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Asian J Neurosurg. 2015 Oct-Dec;10(4):266-71. doi: 10.4103/1793-5482.162685.
Multiple glioblastomas (GBMs) have a reported incidence of 2-20%.
We intend to study these subsets of GBMs to know whether these are similar to their solitary counterparts.
A retrospective study.
We analyzed 7 cases of biopsy-proven multiple GBMs. Multiple GBMs were described if there were >1 lesion which was at least 1 cm apart. The clinical data, radiological features, histopathological and immunohistochemical analysis and follow-up were recorded.
The mean age was 45 years (range 17-69 years). All cases presented with features of raised intracranial pressure (ICP). Totally, 3 cases presented with hemiparesis and 2 cases with altered sensorium and generalized tonic clonic seizures each. The median Karnofsky performance status (KPS) was 50. Mean duration of symptoms was 40 days. All lesions were contrast enhancing (2 with homogenous enhancement and 5 had ring enhancement). Total excision of the lesion causing mass effect was done in all cases. Histopathologically, small cells were significantly present in 4 cases, and satellitosis was seen in 5 cases. Glial fibrillary acidic protein (GFAP) was absent in all cases in which small cells were significant. In these 4 cases, the proliferation index ranged from 40% to 95%. Totally, 3 patients died within 2 months of surgery, whereas remaining 4 patients underwent chemo-radiotherapy.
We conclude that the cases usually present with features of raised ICP and poor KPS. Histopathologically these lesions show significant small cell population, satellitosis, and GFAP negativity.
据报道，多发性胶质母细胞瘤（GBM）的发病率为2%-20%。
我们打算研究这些GBM亚组，以了解它们是否与其单发对应物相似。
一项回顾性研究。
我们分析了7例经活检证实的多发性GBM。如果存在>1个且相互间距至少1 cm的病灶，则描述为多发性GBM。记录临床数据、放射学特征、组织病理学和免疫组织化学分析以及随访情况。
平均年龄为45岁（范围17-69岁）。所有病例均表现为颅内压（ICP）升高的特征。总共3例出现偏瘫，2例分别出现意识改变和全身性强直阵挛性癫痫发作。卡诺夫斯基功能状态（KPS）中位数为50。症状平均持续时间为40天。所有病灶均有强化（2例均匀强化，5例环形强化）。所有病例均对引起占位效应的病灶进行了全切。组织病理学上，4例有明显的小细胞，5例可见卫星现象。在小细胞明显的所有病例中，胶质纤维酸性蛋白（GFAP）均缺失。在这4例中，增殖指数范围为40%-95%。总共3例患者在手术后2个月内死亡，其余4例患者接受了放化疗。
我们得出结论，这些病例通常表现为ICP升高和KPS较差的特征。组织病理学上，这些病灶显示有明显的小细胞群体、卫星现象和GFAP阴性。
