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NEUROLOGYPICTURES CHALLENGE :NEUROLOGYPICTURES CHALLENGE Danil Hammoudi.MD
SINOE MEDICAL ASSOCIATION
Slide 3:Glioblastoma Multiforme
Etiology: • The exact etiology is not known but has to do with several mutations in protooncogenes and tumor suppressor genes. • Some appear as a part of several hereditary syndromes such as neurofibromatosis or Turcot's syndrome.
Pathogenesis:• The cause of the glioblastoma or any brain tumor is not known but changes or loss of chromosome 17 and inactivation of a tumor suppressor gene, p53, play a role. Thus far, we do not know what precipitates these changes.
Epidemiology:• Glioblastomas are the most comman primary brain tumor. • They account for 50% of all gliomas and arise after age 50 in most patients. • Younger patients tend to have a better prognosis than the elderly. • Radiation and chemotherapy appear to extend the life of the patient.
General Gross Description:• The glioblastoma multiforme has a multiform or variable appearance with evidence of old and recent hemorrhage (yellowish-brown to red), necrosis and areas of firm tissue. • Usually the glioblastoma is seen as a mass lesion involving a focal area although it may cross the corpus callosum to the other hemisphere or be multifocal.
General Microscopic Description:• Microscopically the glioblastoma has many forms as well. • Is a highly cellular tumor with pleomorphic, basophilic nuclei with indistinct cytoplasmic borders or plump pink cytoplasm and a delicate fibrillary background. • Mitoses,necrosis, and capillary endothelial proliferation are common.
Clinical Correlations:• The clinical appearance of the glioblastoma is typical for brain tumors in general with a slowly progressive neurological deficit of a focal nature, that is, a slowly progressive hemiparesis of one side of the body. • Prognosis is poor, in that, patients live only 6 month to a year after diagnosis