Faham Btissam, Nsengiyumva Emmanuel Olave, Jamal Oufaa, Makhchoune Marouane, Naja Abdessamad, Lakhdar Abdelhakim
Neurosurgery Department, University Hospital Center IBN ROCHD, Casablanca, Morocco.
Ann Med Surg (Lond). 2023 Apr 13;85(6):2977-2980. doi: 10.1097/MS9.0000000000000593. eCollection 2023 Jun.
Glioblastoma is the most common primary malignant brain tumor in adults. It is enhanced by the abnormal proliferation of central nervous system cells called astrocytes. Microvascular endothelial proliferation is one of the criteria for a histological diagnosis. Hypervascular glioblastoma simulating an arteriovenous malformation is an involuntary manifestation and constitutes a rare entity.
The authors report a case of a 44-year-old patient with no history followed. Symptoms began 6 months ago with the gradual onset of headaches without vomiting or seizures associated with a drop in normal visual acuity without neurological deficit. Cerebral imaging including cerebral angiography concluding with a right parieto-occipital cerebral process probably associated with an arteriovenous malformation.
The management was surgical by biopsy after a right parieto-occipital bone flap concluding in glioblastoma. The patient needs chemotherapy and radiotherapy sessions with good clinical evolution.
The coexistence of an arteriovenous malformation and glioblastoma remains an association whose pathophysiology still remains to be explored.
胶质母细胞瘤是成人中最常见的原发性恶性脑肿瘤。它由称为星形胶质细胞的中枢神经系统细胞异常增殖所致。微血管内皮细胞增殖是组织学诊断标准之一。模拟动静脉畸形的高血管性胶质母细胞瘤是一种非自主性表现,构成一种罕见实体。
作者报告一例44岁患者,此前无病史记录。症状始于6个月前,逐渐出现头痛,无呕吐或癫痫发作,伴有正常视力下降且无神经功能缺损。包括脑血管造影在内的脑部影像学检查结果显示,右侧顶枕部脑部病变可能与动静脉畸形有关。
经右侧顶枕部骨瓣开颅活检后确诊为胶质母细胞瘤,采取手术治疗。患者需要进行化疗和放疗,目前临床病情进展良好。
动静脉畸形与胶质母细胞瘤并存仍是一种关联,其病理生理学仍有待探索。