Hammoud Marouane, Hmamouche Oualid Mohammed, Lakhdar Faycal, Benzagmout Mohammed, Chakour Khalid, Chaoui Mohammed El Faiz
Department of Neurosurgery, University Hospital of Fez, Morocco.
Surg Neurol Int. 2024 Jan 26;15:25. doi: 10.25259/SNI_809_2023. eCollection 2024.
Pediatric glioblastoma multiforme (p-GBM) is an exceptionally rare and aggressive brain tumor, with even fewer reported cases with radiographic and intraoperative characteristics that mimic those of extra-axial lesions, often posing a diagnostic challenge. Despite advancements in imaging technologies, the diagnosis of GBM can still be intricate, relying primarily on histopathological confirmation.
We present a unique case of a 15-year-old female who presented to our hospital with a new-onset focal-to-bilateral tonic-clonic seizure described as clonic movements of her left hemicorps; on clinical examination, a subcutaneous mass was evident in the right parietal region. Magnetic resonance imaging of the brain revealed a sizable extra-axial enhancing mass measuring 9 cm, located in the right parieto-occipital region with notable bone invasion. Moreover, the intraoperative findings revealed an extra-axial mass attached to the dura. Total resection was achieved. The histopathological analysis confirmed the diagnosis of glioblastoma multiforme. Subsequently, the patient underwent adjuvant radiotherapy in conjunction with temozolomide chemotherapy. Postoperatively, she exhibited clinical improvement and remained stable throughout the 6-month follow-up period.
We present the first case of extra-axial p-GBM in a young patient, which remarkably led to the destruction of the bone and finally resulted in a sizable parietal subcutaneous lesion in the absence of prior surgery or radiation.
儿童多形性胶质母细胞瘤(p-GBM)是一种极为罕见且侵袭性强的脑肿瘤,报告的具有类似轴外病变影像学和术中特征的病例更少,这常常带来诊断挑战。尽管成像技术有所进步,但胶质母细胞瘤的诊断仍可能很复杂,主要依靠组织病理学确诊。
我们报告一例独特病例,一名15岁女性因新发局灶性至双侧强直阵挛性发作就诊于我院,发作表现为左侧半侧身体的阵挛运动;临床检查发现右顶叶区域有一个皮下肿块。脑部磁共振成像显示一个位于右顶枕区域、大小为9厘米的轴外强化肿块,伴有明显的骨质侵犯。此外,术中发现一个附着于硬脑膜的轴外肿块。实现了全切。组织病理学分析确诊为多形性胶质母细胞瘤。随后,患者接受了辅助放疗联合替莫唑胺化疗。术后,她的临床症状有所改善,在6个月的随访期内病情保持稳定。
我们报告了首例年轻患者的轴外p-GBM病例,该病例显著导致骨质破坏,最终在未进行过先前手术或放疗的情况下形成了一个较大的顶叶皮下病变。