Glioblastoma multiforme overview: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Glioblastoma multiforme}} | {{Glioblastoma multiforme}} | ||
{{CMG}} | {{CMG}}{{AE}}{{SR}} | ||
==Overview== | ==Overview== | ||
Glioblastoma multiforme is | |||
==Historical Perspective== | |||
Glioblastoma multiforme was first coined by Percival Bailey and Harvey Cushing in 1926.<ref name=ddd>Terminology of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Classification== | |||
Glioblastoma multiforme may be classified into several subtypes based on the origin and molecular alterations.<ref name=ddd>Classification of Glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/Glioblastoma multiforme</ref><ref name="pmid20129251">{{cite journal| author=Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD et al.| title=Integrated genomic analysis identifies clinically relevant subtypes of Glioblastoma multiforme characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. | journal=Cancer Cell | year= 2010 | volume= 17 | issue= 1 | pages= 98-110 | pmid=20129251 | doi=10.1016/j.ccr.2009.12.020 | pmc=PMC2818769 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20129251 }} </ref> | |||
==Pathophysiology== | |||
Glioblastoma multiforme is characterized by the presence of small areas of [[Necrosis|necrotizing]] tissue that are surrounded by [[anaplastic]] cells. Genes involved in the pathogenesis of glioblastoma multiforme include ''[[Mdm2]]'', ''[[PTEN]]'', ''IDH1'', ''[[p53]]'', and chromosomes 10p, 10q, 17p, and 19q. On gross pathology, the characteristic findings of glioblastoma multiforme include a poorly-marginated, diffusely infiltrating, firm or gelatinous mass with central [[necrosis|necrotic]] core. On microscopic histopathological analysis, the characteristic findings of Glioblastoma multiforme include [[pleomorphic]] [[astrocytes]] with marked [[atypia]], [[mitosis]], [[necrosis]], and microvascular proliferation.<ref name=ddd>Pathology of Glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/Glioblastoma multiforme</ref> | |||
==Causes== | |||
There are no established causes for glioblastoma multiforme.<ref name=ddd>Etiology of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Differentiating brain tumors from other diseases== | |||
Glioblastoma multiforme must be differentiated from [[Metastasis|cerebral metastasis]], [[primary CNS lymphoma]], [[cerebral abscess]], [[Astrocytoma|anaplastic astrocytoma]], [[Demyelination|tumefactive demyelination]], [[stroke]], [[Toxoplasmosis|cerebral toxoplasmosis]], [[Radiation|radiation necrosis]], [[encephalitis]], [[oligodendroglioma]], and [[epilepsy]].<ref name=ddd>DDx of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Epidemiology and Demographics== | |||
Glioblastoma multiforme is the the most common adult primary intracranial neoplasm worldwide.<ref name=ddd>Epidemiology of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> The incidence of glioblastoma multiforme is estimated to be 3.2 cases per 100,000 individuals worldwide.<ref name="pmid25053711">{{cite journal| author=Thakkar JP, Dolecek TA, Horbinski C, Ostrom QT, Lightner DD, Barnholtz-Sloan JS et al.| title=Epidemiologic and molecular prognostic review of glioblastoma. | journal=Cancer Epidemiol Biomarkers Prev | year= 2014 | volume= 23 | issue= 10 | pages= 1985-96 | pmid=25053711 | doi=10.1158/1055-9965.EPI-14-0275 | pmc=PMC4185005 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25053711 }} </ref> Glioblastoma multiforme is a common disease that tends to affect older adult and elderly population. The median age at diagnosis is 64 years.<ref name="pmid25053711">{{cite journal| author=Thakkar JP, Dolecek TA, Horbinski C, Ostrom QT, Lightner DD, Barnholtz-Sloan JS et al.| title=Epidemiologic and molecular prognostic review of glioblastoma. | journal=Cancer Epidemiol Biomarkers Prev | year= 2014 | volume= 23 | issue= 10 | pages= 1985-96 | pmid=25053711 | doi=10.1158/1055-9965.EPI-14-0275 | pmc=PMC4185005 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25053711 }} </ref> Males are more commonly affected with glioblastoma multiforme than females. The male to female ratio is approximately 1.5:1. Glioblastoma multiforme usually affects individuals of the caucasian race. | |||
==Risk factors== | |||
Common risk factors in the development of glioblastoma multiforme are [[Radiation|radiation exposure]], [[viruses]], [[polyvinyl chloride]], [[alcohol]], and [[Genetic|genetic disorders]].<ref name=ddd>Risk factors of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Screening== | |||
Screening for glioblastoma multiforme is not recommended. | |||
==Natural History, Complications and Prognosis== | |||
Common complications of glioblastoma multiforme include [[herniation]], [[systemic]] illness, [[brainstem]] invasion by [[tumor]], neutron-induced cerebral injury, [[weakness]], [[fatigue]], [[numbness]], [[surgical]] complications, and [[coma]].<ref name="pmid1654403">{{cite journal| author=Silbergeld DL, Rostomily RC, Alvord EC| title=The cause of death in patients with glioblastoma is multifactorial: clinical factors and autopsy findings in 117 cases of supratentorial glioblastoma in adults. | journal=J Neurooncol | year= 1991 | volume= 10 | issue= 2 | pages= 179-85 | pmid=1654403 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1654403 }} </ref> Prognosis is generally poor, and the 5-year survival rate of patients with glioblastoma multiforme is less than 10%. | |||
==Staging== | |||
There is no established system for the staging of glioblastoma multiforme. | |||
==History and Symptoms== | |||
Common symptoms of glioblastoma multiforme include [[headache]], [[seizure]], [[memory loss]], [[irritability]], changes in speech, difficulty reading or concentrating, [[drowsiness]], [[nausea]], [[vomiting]], [[muscle weakness]], [[sensory loss]], [[diplopia]], [[blurred vision]], [[vertigo]], [[hearing loss]], and [[hiccups]].<ref name=ddd>Presentation of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Physical examination== | |||
Common physical examination findings of glioblastoma multiforme include [[personality changes]], [[memory loss]], [[aphasia]], [[hemiparesis]], [[sensory loss]], and [[ataxia]].<ref name=ddd>Signs of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Laboratory Findings== | |||
There are no diagnostic lab findings associated with glioblastoma multiforme. | |||
==X Ray== | |||
There are no x-ray findings associated with glioblastoma multiforme. | |||
==CT== | |||
Head CT scan is helpful in the diagnosis of glioblastoma multiforme. On head CT scan, glioblastoma multiforme is characterized by a butterfly shaped mass with marked midline shift, irregular and heterogenous enhancement of margins, necrotic center, surrounding vasogenic [[edema]], and [[hemorrhage]].<ref name=ddd>XYZ of glioblastoma multiforme multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma multiforme</ref> | |||
==MRI== | |||
Brain MRI is helpful in the diagnosis of glioblastoma multiforme. On brain MRI, glioblastoma multiforme is characterized by hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.<ref name=ddd>XYZ of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | |||
==Ultrasound== | |||
==Other Imaging Findings== | |||
==Other Diagnostic Studies== | |||
==Medical Therapy== | |||
==Surgery== | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Neurology]] | |||
[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
Revision as of 18:22, 18 September 2015
|
Glioblastoma multiforme Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Glioblastoma multiforme overview On the Web |
|
American Roentgen Ray Society Images of Glioblastoma multiforme overview |
|
Risk calculators and risk factors for Glioblastoma multiforme overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Historical Perspective
Glioblastoma multiforme was first coined by Percival Bailey and Harvey Cushing in 1926.[1]
Classification
Glioblastoma multiforme may be classified into several subtypes based on the origin and molecular alterations.[1][2]
Pathophysiology
Glioblastoma multiforme is characterized by the presence of small areas of necrotizing tissue that are surrounded by anaplastic cells. Genes involved in the pathogenesis of glioblastoma multiforme include Mdm2, PTEN, IDH1, p53, and chromosomes 10p, 10q, 17p, and 19q. On gross pathology, the characteristic findings of glioblastoma multiforme include a poorly-marginated, diffusely infiltrating, firm or gelatinous mass with central necrotic core. On microscopic histopathological analysis, the characteristic findings of Glioblastoma multiforme include pleomorphic astrocytes with marked atypia, mitosis, necrosis, and microvascular proliferation.[1]
Causes
There are no established causes for glioblastoma multiforme.[1]
Differentiating brain tumors from other diseases
Glioblastoma multiforme must be differentiated from cerebral metastasis, primary CNS lymphoma, cerebral abscess, anaplastic astrocytoma, tumefactive demyelination, stroke, cerebral toxoplasmosis, radiation necrosis, encephalitis, oligodendroglioma, and epilepsy.[1]
Epidemiology and Demographics
Glioblastoma multiforme is the the most common adult primary intracranial neoplasm worldwide.[1] The incidence of glioblastoma multiforme is estimated to be 3.2 cases per 100,000 individuals worldwide.[3] Glioblastoma multiforme is a common disease that tends to affect older adult and elderly population. The median age at diagnosis is 64 years.[3] Males are more commonly affected with glioblastoma multiforme than females. The male to female ratio is approximately 1.5:1. Glioblastoma multiforme usually affects individuals of the caucasian race.
Risk factors
Common risk factors in the development of glioblastoma multiforme are radiation exposure, viruses, polyvinyl chloride, alcohol, and genetic disorders.[1]
Screening
Screening for glioblastoma multiforme is not recommended.
Natural History, Complications and Prognosis
Common complications of glioblastoma multiforme include herniation, systemic illness, brainstem invasion by tumor, neutron-induced cerebral injury, weakness, fatigue, numbness, surgical complications, and coma.[4] Prognosis is generally poor, and the 5-year survival rate of patients with glioblastoma multiforme is less than 10%.
Staging
There is no established system for the staging of glioblastoma multiforme.
History and Symptoms
Common symptoms of glioblastoma multiforme include headache, seizure, memory loss, irritability, changes in speech, difficulty reading or concentrating, drowsiness, nausea, vomiting, muscle weakness, sensory loss, diplopia, blurred vision, vertigo, hearing loss, and hiccups.[1]
Physical examination
Common physical examination findings of glioblastoma multiforme include personality changes, memory loss, aphasia, hemiparesis, sensory loss, and ataxia.[1]
Laboratory Findings
There are no diagnostic lab findings associated with glioblastoma multiforme.
X Ray
There are no x-ray findings associated with glioblastoma multiforme.
CT
Head CT scan is helpful in the diagnosis of glioblastoma multiforme. On head CT scan, glioblastoma multiforme is characterized by a butterfly shaped mass with marked midline shift, irregular and heterogenous enhancement of margins, necrotic center, surrounding vasogenic edema, and hemorrhage.[1]
MRI
Brain MRI is helpful in the diagnosis of glioblastoma multiforme. On brain MRI, glioblastoma multiforme is characterized by hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.[1]
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Medical Therapy
Surgery
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 Terminology of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma
- ↑ Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD; et al. (2010). "Integrated genomic analysis identifies clinically relevant subtypes of Glioblastoma multiforme characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1". Cancer Cell. 17 (1): 98–110. doi:10.1016/j.ccr.2009.12.020. PMC 2818769. PMID 20129251.
- ↑ 3.0 3.1 Thakkar JP, Dolecek TA, Horbinski C, Ostrom QT, Lightner DD, Barnholtz-Sloan JS; et al. (2014). "Epidemiologic and molecular prognostic review of glioblastoma". Cancer Epidemiol Biomarkers Prev. 23 (10): 1985–96. doi:10.1158/1055-9965.EPI-14-0275. PMC 4185005. PMID 25053711.
- ↑ Silbergeld DL, Rostomily RC, Alvord EC (1991). "The cause of death in patients with glioblastoma is multifactorial: clinical factors and autopsy findings in 117 cases of supratentorial glioblastoma in adults". J Neurooncol. 10 (2): 179–85. PMID 1654403.