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Cerebellar glioblastoma multiforme in an adult woman

Abstract

Aims and background. Glioblastoma multiforme (GBM) is the most frequent primary central nervous system malignancy in adults, accounting for 50% of all primary intracranial malignancies. GBM mostly arises within the cerebral hemispheres and frequently affects patients in the fifth and sixth decades of life. Conversely, primary cerebellar GBM is a rather infrequent occurrence in the adult population, accounting for 1%-2.2% of all GBMs. Here we report a case of cerebellar GBM in an adult woman and provide an extensive review of the literature.
Methods. A 42-year-old woman was referred to our hospital for occipital constrictive headache, dizziness and gait disturbance. Multimodality imaging including computed tomography and magnetic resonance imaging (MRI) showed a right cerebellar mass. Gross total resection was performed. Histological examination showed grade IV GBM according to the World Health Organization classification, with a synchronous component of low-grade glioma. Immunohistochemistry showed positivity for p53 and negativity for epidermal growth factor receptor (EGFR). After surgical tumor excision, the patient underwent adjuvant radiation to the posterior fossa with an intensity-modulated approach for a total dose of 60 Gy in 30 fractions. In addition, she received concurrent and adjuvant chemotherapy with temozolomide.
Results. Treatment was well tolerated, with mild acute toxicity. There was no evidence of recurrence on brain and spinal gadolinium-enhanced MRI scans 4, 8 and 12 months after primary surgery. No late side effects were recorded.
Conclusion. Our patient had several immunohistochemical characteristics of secondary glioblastoma such as p53 positivity, EGFR negativity and the presence of a low-grade glioma component. Intensity-modulated radiation therapy allowed us to safely deliver full-dose radiation with sparing of critical structures.

Tumori 2014; 100(3): e74 - e78

Article Type: CASE REPORT

DOI:10.1700/1578.17236

Authors

Piera Sciacero, Giuseppe Franco Girelli, Domenico Cante, Pierfrancesco Franco, Valeria Casanova Borca, Pierangelo Grosso, Annamaria Marra, Sebastiano Bombaci, Santi Tofani, Maria Rosa La Porta, Umberto Ricardi

Article History

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Authors

  • Sciacero, Piera [PubMed] [Google Scholar]
    Department of Radiation Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Girelli, Giuseppe Franco [PubMed] [Google Scholar]
    Department of Radiation Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Cante, Domenico [PubMed] [Google Scholar]
    Department of Radiation Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Franco, Pierfrancesco [PubMed] [Google Scholar]
    Radiation Oncology Department, Tomotherapy Unit, U Parini Hospital, AUSL Valle d’Aosta, Aosta, Italy
  • Borca, Valeria Casanova [PubMed] [Google Scholar]
    Department of Medical Physics, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Grosso, Pierangelo [PubMed] [Google Scholar]
    Department of Medical Physics, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Marra, Annamaria [PubMed] [Google Scholar]
    Department of Radiation Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Bombaci, Sebastiano [PubMed] [Google Scholar]
    Department of Medical Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Tofani, Santi [PubMed] [Google Scholar]
    Department of Medical Physics, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Porta, Maria Rosa La [PubMed] [Google Scholar]
    Department of Radiation Oncology, ASL TO 4, Ivrea Community Hospital, Ivrea, Italy
  • Ricardi, Umberto [PubMed] [Google Scholar]
    Department of Oncology, University of Turin, Turin, Italy

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