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Case Reports
. 2010 Dec 22:1:87.
doi: 10.4103/2152-7806.74146.

Unusual manifestations of primary Glioblastoma Multiforme: A report of three cases

Ahmet Metin Sanli  1 , Erhan Turkoglu, Habibullah Dolgun, Zeki Sekerci
Affiliations
Case Reports

Unusual manifestations of primary Glioblastoma Multiforme: A report of three cases

Ahmet Metin Sanli et al. Surg Neurol Int. .

Abstract

Background: Brain tumors, especially high-grade gliomas, can present with focal or generalized signs due to mass effect, parenchymal infiltration and destruction. In general, at the time of diagnosis, tumors could cause common neurological symptoms and major clinical signs depending on their localization. In rare instances, brain tumors colud be manifested with unusual symptoms.

Case description: WE DESCRIBE THREE CASES PRESENTING WITH UNUSUAL CLINICAL SYMPTOMS: ulnar neuropathy, vertigo and syncope attacks. Microscopic total tumor excision was done and histopathological analysis revealed that these tumors were glioblastoma multiforme. Both external beam radiotherapy and chemotherapy were given as adjuvant treatments.

Conclusions: Physicians should keep brain tumors in mind in the case of patients who present with atypical symptoms such as those reported here. Brain imaging should be performed over a prolonged period following presentation if the patient's symptoms remain unresolved after adequate treatment.

Keywords: Astrocytoma; brain tumor; glioblastoma multiforme; presentation; symptom.

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Figures

Figure 1
Figure 1
Cranial axial MRI with gadolinium revealing a ring-enhancing 4 × 4.5 cm mass lesion in the right parietal lobe with significant surrounding peripheral edema.
Figure 2
Figure 2
(a) T1-weighted axial cranial MRI without contrast revealing a hypointense lesion in the left parieto-occipital region causing a minimal midline shift (b) MR spectroscopy demonstrated an increased lactate peak, decreased N- acetylaspartate (NAA) peak and creatinin (Cr). These findings suggest that the appearance could be geared to acute intracerebral hematoma
Figure 3
Figure 3
(a, b) Cranial MRI with gadolinium revealing a 6 × 5 × 4 cm left-sided parieto-occipital lesion with brain edema, associated mass effect and uncal herniation. The lesion was composed of cystic tissue separated by various fibrous septae. The tumor was hyperintense on T1-(a) and T2-(b) weighted images and showed heterogeneous enhancement with contrast peripherally.
Figure 4
Figure 4
Cranial axial MRI with contrast showing a 1.5 × 2 cm nodular tumor, localized in the right lateral recess of the forth ventricle and showing homogenous enhancement.
See this image and copyright information in PMC

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