Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany.
University of Wuerzburg, Neuropathology, Wuerzburg, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2020 Sep;81(5):418-422. doi: 10.1055/s-0039-1698389. Epub 2020 Jan 21.
Glioblastoma multiforme (GBM) is the most frequent malignant neoplasm in the adult brain. In contrast, arteriovenous malformations (AVMs) are presumably congenital lesions, usually presenting with hemorrhage. Hypervascular low-grade gliomas associated with AVMs were previously called "angioglioma." An association of AVMs and GBM was also described.
We discuss the data of the largest series of locally coincident GBM with AVM in a single institution so far. All analyses were explorative only.
We report a series of four patients presenting at our department from 2006 to 2014. All patients underwent surgery. The cases were analyzed regarding initial presentation, clinical findings, tumor localization, and histopathologic results.
A local coincidence of cerebral AVM and GBM is rare. Only a few reports can be found in the literature. The radiologic as well as the clinical presentations are individual. Proangiogenic factors are discussed as involved in the appearance of both entities in the same location. However, the presence of pathologic vessels within malignant gliomas is well known to all neurosurgeons and proangiogenic activity has been proven. Therefore, it seems possible that tumor activity itself contributes to the pathogenesis of a vascular malformation.
多形性胶质母细胞瘤（GBM）是成人脑内最常见的恶性肿瘤。相比之下，动静脉畸形（AVM）可能是先天性病变，通常表现为出血。与 AVM 相关的高血管低级别胶质瘤以前被称为“血管胶质瘤”。也有描述 AVM 和 GBM 之间的关联。
我们讨论了迄今为止单一机构中局部同时存在 GBM 和 AVM 的最大系列数据。所有分析均为探索性分析。
我们报告了 2006 年至 2014 年期间在我院就诊的 4 名患者的系列病例。所有患者均接受了手术。对病例进行了初始表现、临床发现、肿瘤定位和组织病理学结果的分析。
脑 AVM 和 GBM 的局部巧合非常罕见。在文献中只有少数报道。影像学和临床表现是个体差异的。促血管生成因子被认为与同一部位的两种实体的出现有关。然而，所有神经外科医生都知道恶性胶质瘤内存在病理性血管，并且已经证明了促血管生成活性。因此，肿瘤活性本身似乎有可能导致血管畸形的发病机制。
