Glioblastoma Multiforme is a malignant brain cancer originating from astrocytes and oligodendrocytes. Glioblastoma Multiforme cases most often occur in adults 40-70 years. The cause of Glioblastoma Multiforme is not yet known, but it is thought to have something to do with radiation exposure.
Primary Glioblastoma ➡️
Other name : IDH-WILDTYPE
Average age : 62 years
Disease course : Fast
Location : Supratentorial
Necrosis : Extensive
Surgery + Radiotherapi : 9.9 months
Surgery + Radiotherapy + Chemotherapy : 15 months
Etiopathogenesis :
- Epidermal Growth Factor Receptor overexpression/amplification.
- Loss of heterozygosity of Ch. 10q.
- Phospataste and Tensine Homologous Deletions in Ch. 10.
- P16 deletion.
Secondary Glioblastoma ️➡️
Other name : IDH-MUTANT
Average age : 44 years old
Disease course : Slow
Location : Frontal
Necrosis : Limited
Surgery + Radiotherapy : 24 months
Surgery + Radiotherapy + Chemotherapy : 31 months
Etiopathogenesis :
- Platelet-driven Growth Factor Receptor overexpression.
- Loss of heterozygosity of Ch. 10q.
- p53 mutation.
- Deviation p16/Rb
Symptom.
Symptoms of Glioblastoma Multiforme depend on the size and location of the brain involved :
- Persistent headache.
- Double view.
- Gag.
- Loss of appetite.
- Impaired ability to think and learn.
- New onset seizures.
- Difficulty speaking that comes on slowly.
Diagnosis.
Diagnosis can be made using Computed Tomography (CT/CAT SCAN) and Magnetic Resonance Imaging (MRI).
General description in the form of :
- Infiltrative Lesions.
- Heterogeneous.
- Ring-enhancing with central necrosis and peritumor edema.
Intraoperative MRI may be performed to assist with biopsy and removal of the tumor.
Magnetic Resonance Spectroscopy (MRS) is used to view the chemical profile of the tumor.
Positron Emission Tomography (PET SCAN) to detect tumor recurrence.
Treatment.
- The common treatment is surgery, followed by radiation therapy and chemotherapy. Aims to remove the tumor as much as possible without damaging the surrounding tissue.
- Craniotomy is performed while the patient is awake, so that the operator can map the anatomical location during surgery, deciding which areas are safe for resection.
- After the craniotomy was completed, it was followed by multiple external beam radiation therapy.
- The chemotherapy drug temozolomide is combined with radiation therapy (bevacizumad, cisplatin, vincristine, lomustine, carmustine, etoposide and procabazine).
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