Zhang Zuo-Xin, Chen Ju-Xiang, Shi Bao-Zhong, Li Guang-Hui, Li Yao, Xiang Yan, Qin Xun, Yang Lin, Lv Sheng-Qing
Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University, No.183 Xinqiao Street, Shapingba District, Chongqing City, 400037, People's Republic of China.
Department of Neurosurgery, Changzheng Hospital and Shanghai Institute of Neurosurgery, Second Military Medical University, Shanghai, 200003, People's Republic of China.
Chin Neurosurg J. 2021 Jan 15;7(1):8. doi: 10.1186/s41016-020-00223-z.
Multifocal glioblastoma is a rare type of glioblastoma with worse prognosis. In this article, we aimed to report two cases of classical multifocal glioblastoma.
In case 1, a 47-year-old male presented with dizziness, and once had a sudden loss of consciousness accompanied by convulsion of limbs. Contrast-enhanced MRI showed multiple lesions with heterogeneously ring-enhanced characters in the left hemisphere, diagnosed as multifocal glioblastoma. He underwent a craniotomy of all lesions, concurrent radiotherapy and chemotherapy as well as additional chemotherapy of temozolomide. After 2 cycles, repeat MRI showed that the new lesions already occurred and progressed. Eventually, he abandoned the chemotherapy after the 2 cycles and died 1 year later. In case 2, a 71-year-old male presented with a history of headache, left limb weakness, and numbness. Discontinuous convulsion of limbs once occurred. Contrast-enhanced MRI showed multiple lesions located in the right hemisphere, diagnosed as multifocal glioblastoma. He underwent a right frontoparietal craniotomy of the main lesion. Hemorrhage of the residual tumor and pulmonary artery embolism occurred synchronously. Eventually, his family decided not to pursue any further treatment and opted for hospice care and he passed away within 11 days of surgery.
We reported two cases of typical multifocal glioblastoma. Valid diagnosis is crucial; then, resection of multiple lesions and canonical radio-chemotherapy probably bring survival benefits.
多灶性胶质母细胞瘤是胶质母细胞瘤的一种罕见类型，预后较差。在本文中，我们旨在报告两例经典的多灶性胶质母细胞瘤病例。
病例1，一名47岁男性，出现头晕症状，曾有一次突发意识丧失并伴有肢体抽搐。增强磁共振成像（MRI）显示左半球有多个具有不均匀环形强化特征的病灶，诊断为多灶性胶质母细胞瘤。他接受了所有病灶的开颅手术、同步放化疗以及替莫唑胺的辅助化疗。2个周期后，复查MRI显示新病灶已出现并进展。最终，他在2个周期后放弃化疗，1年后死亡。病例2，一名71岁男性，有头痛、左下肢无力和麻木病史。曾发生过肢体间断抽搐。增强MRI显示右半球有多个病灶，诊断为多灶性胶质母细胞瘤。他接受了主要病灶的右额顶开颅手术。残余肿瘤出血和肺动脉栓塞同时发生。最终，他的家人决定不再寻求进一步治疗，选择了临终关怀，他在手术后11天内去世。
我们报告了两例典型的多灶性胶质母细胞瘤病例。准确的诊断至关重要；然后，切除多个病灶以及规范的放化疗可能带来生存益处。
