Edelbach Brandon, Gospodarev Vadim, Lopez-Gonzalez Miguel, Deisch Jeremy, Kaur Maninder
School of Medicine, Loma Linda University, Loma Linda, CA, United States.
Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, CA, United States.
Front Oncol. 2024 Mar 13;14:1279897. doi: 10.3389/fonc.2024.1279897. eCollection 2024.
Diffuse pontine glioblastoma multiforme is a rare subtype of glioblastoma associated with a poor prognosis. In this case report, we present a unique case of diffuse primary pontine glioblastoma multiforme in a patient without any supratentorial lesions. We review the symptoms, treatment options, and case management of patients with infratentorial glioblastoma multiforme and compare these with our patient. Our patient presented with symptoms including progressive diplopia, gait disturbance, and lower extremity weakness. Magnetic resonance imaging revealed a diffuse lesion involving the pons and biopsy revealed only mildly-atypical glial infiltrates. Consequentially, diagnosis was driven by genetic analysis. Due to the location of the tumor, surgery was not considered a viable option. Instead, the patient received radiation therapy along with concomitant and adjuvant temozolomide chemotherapy which has resulted in improvement of symptoms. This case highlights the challenges of managing diffuse primary pontine glioblastoma multiforme and the need for more effective treatment options for this rare subtype of glioblastoma. Despite aggressive treatment, the prognosis for patients with infratentorial glioblastoma multiforme remains poor, with a median survival time of less than a year. Further research is needed to improve our understanding of the biology and optimal management of this disease.
弥漫性脑桥多形性胶质母细胞瘤是胶质母细胞瘤的一种罕见亚型，预后较差。在本病例报告中，我们呈现了一例独特的弥漫性原发性脑桥多形性胶质母细胞瘤病例，该患者无任何幕上病变。我们回顾了幕下多形性胶质母细胞瘤患者的症状、治疗选择和病例管理，并将其与我们的患者进行比较。我们的患者出现了包括进行性复视、步态障碍和下肢无力等症状。磁共振成像显示脑桥有弥漫性病变，活检仅显示轻度非典型胶质浸润。因此，诊断是通过基因分析得出的。由于肿瘤的位置，手术不是一个可行的选择。相反，患者接受了放射治疗以及同步和辅助替莫唑胺化疗，症状得到了改善。该病例突出了管理弥漫性原发性脑桥多形性胶质母细胞瘤的挑战以及对这种罕见的胶质母细胞瘤亚型需要更有效的治疗选择。尽管进行了积极治疗，幕下多形性胶质母细胞瘤患者的预后仍然很差，中位生存时间不到一年。需要进一步研究以增进我们对这种疾病生物学特性和最佳管理方法的理解。
