Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
April 2015
Next Case of the Month coming May 5 . . .
Glioblastoma
- Glioblastoma is a WHO Grade IV tumor.
- Most common primary CNS tumor — approximately 20% of all such tumors
- Two main subtypes: primary and secondary
- Clinical Presentation: Headaches, seizures, neurologic deficits, etc.
- Key Diagnostic Features:
- Often heterogeneously enhancing lesion with central necrosis.
- Diffusion restriction from cellular components of tumor
- Hemorrhage can be seen.
- Increased perfusion on DSC-MRI
- Markedly elevated Cho:Cr and lipid-lactate peak on MRS
- DDx:
- Metastases
- Infection (abscess)
- Demyelinating lesion
- Radiation necrosis
- Pseudoprogression
- Rx:
- Stupp protocol — surgical excision followed by radiotherapy with concomitant and adjucvant temozolomide
- Bevacizumab for recurrence
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