Glioblastoma multiforme

Glioblastoma multiforme is a malignant brain tumor that carries an extremely poor prognosis.

Signs and symptoms

• Symptoms of increased intracranial pressure including headache, pappiledema (optic disc swelling), nausea or vomiting, and diplopia (double vision).

Treatment

Currently, most patients with glioblastoma multiforme are first treated with maximal surgical removal of the tumor, which is then followed by radiotherapy and chemotherapy, most often with temozolomide, a chemotheraputic agent that has been shown to have activity against glioblastoma multiforme. Radiosurgery is being investigated in the treatment of glioblastoma multiforme.

Glioblastoma Multiforme Media

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  GBM in the frontal right lobe as seen on CT scan

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  Sagittal MRI with contrast of a glioblastoma WHO grade 4 in a 15-year-old boy

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  Diagnostic algorithm of diffuse glioma

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  Management of IDH wild type glioblastoma, WHO grade 4. KPS, Karnofsky performance status.

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  Glioblastoma pre (left) and post (right) resection

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  Radiation treatment planning for glioblastoma. GTV: gross tumor volume, CTV: clinical target volume, PTV: planning target volume.

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  Histopathology of glioblastoma, showing high grade astrocytoma features of marked nuclear pleomorphism, multiple mitoses (one at white arrow) and multinucleated cells (one at black arrow), with cells having a patternless arrangement in a pink fibrillary background on H&E stain

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  Lower magnification histopathology, showing necrosis surrounded by pseudopalisades of tumor cells, conferring a diagnosis of glioblastoma rather than anaplastic astrocytoma