This document summarizes a case report of a 29-year-old man diagnosed with glioblastoma multiforme (GBM). He presented with chronic progressive headaches, blurred vision, seizures, nausea and vomiting for 8 months. Imaging showed a solitary lesion in the frontal region. Histopathological examination confirmed GBM. The patient was treated with symptomatic medications and tumor resection. GBM is the most common and aggressive primary brain tumor, typically affecting older adults. Symptoms vary based on tumor size and location but often include headaches, seizures, and neurological deficits. Prognosis is generally poor with median survival of 12-15 months even with surgery, radiation and chemotherapy.
This document summarizes a case report of a 29-year-old man diagnosed with glioblastoma multiforme (GBM). He presented with chronic progressive headaches, blurred vision, seizures, nausea and vomiting for 8 months. Imaging showed a solitary lesion in the frontal region. Histopathological examination confirmed GBM. The patient was treated with symptomatic medications and tumor resection. GBM is the most common and aggressive primary brain tumor, typically affecting older adults. Symptoms vary based on tumor size and location but often include headaches, seizures, and neurological deficits. Prognosis is generally poor with median survival of 12-15 months even with surgery, radiation and chemotherapy.
This document summarizes a case report of a 29-year-old man diagnosed with glioblastoma multiforme (GBM). He presented with chronic progressive headaches, blurred vision, seizures, nausea and vomiting for 8 months. Imaging showed a solitary lesion in the frontal region. Histopathological examination confirmed GBM. The patient was treated with symptomatic medications and tumor resection. GBM is the most common and aggressive primary brain tumor, typically affecting older adults. Symptoms vary based on tumor size and location but often include headaches, seizures, and neurological deficits. Prognosis is generally poor with median survival of 12-15 months even with surgery, radiation and chemotherapy.
This document summarizes a case report of a 29-year-old man diagnosed with glioblastoma multiforme (GBM). He presented with chronic progressive headaches, blurred vision, seizures, nausea and vomiting for 8 months. Imaging showed a solitary lesion in the frontal region. Histopathological examination confirmed GBM. The patient was treated with symptomatic medications and tumor resection. GBM is the most common and aggressive primary brain tumor, typically affecting older adults. Symptoms vary based on tumor size and location but often include headaches, seizures, and neurological deficits. Prognosis is generally poor with median survival of 12-15 months even with surgery, radiation and chemotherapy.
Download as PPT, PDF, TXT or read online from Scribd
Download as ppt, pdf, or txt
You are on page 1/ 27
Hening Widjayanti
Lecturer : dr.Sutedjo, SpS
(K)
ABSTRACT GLIOBLASTOMA MULTIFORME Hening Widjayanti* Soetedjo ** Background:.Glioblastoma (GBM) is the most common glioma (a type of cancer of the brain) where the tumor is found most malignant brain that comes from glial cellsAnaplasticastrocytomasaffectmales slightly more often than females. The symptoms of glioblastoma multiforme vary depending uponthe exactlocation and sizeofthetumor.Anglioblastomamultiformeusuallydevelopsslowlyovertime,butmaydeveloprapidly. CaseReport:Reportedcaseofaman,29 years old man, Javannesse, a housewife, right handed, married, came with chief complaint chronic progressive headache, blurred vision, seizures, nausea and vomiting since 8 months before admission. On contrast head CT scan appeared SOL in Frontal. A collection of signs and symptoms consistent leading to increased Intracranial Pressure due to SOL Frontal Region.. From the physical examination found cerebellar signs The hystopathologicalexaminationwasglioblastomamultiforme.Byanamnesis,physicalexamination,andimagingstudy,tend to be a SOL in the frontal. The management of patients with symptomatic treatment and resection of the tumor. HystopathologicexaminationresultssupportthediagnosisofGlioblastomaMultiforme Conclusion Reported case a patients with vestibular vertigo, chronic progressive cephalgia, and ataxia accompanied by nausea and vomitingsince3months.Acollectionofsignsandsymptomsinpatientsconsistentwithincreasedintracranialpressuredue to the mass in the cerebellum. Management of these patients are sympotamatic medication and tumor resection, with hystopathologic examination. Hystopathologic examination results is Glioblastoma Multiforme During the postoperative care,patient'sconditionisthesame,butbetter. Keyword:GlioblastomaMUltiforme,diagnosis,prognosis,theraphy
INTRODUCTION Glioblastoma is usually found in adults consists of a heterogeneous mixture of poorly differentiated neoplastic astrocytes which are located in the cerebral hemispheres
Primary glioblastoma multiforme majority of cases (60%) obtained
in adults older than 50 years. Secondary glioblastoma multiforme (40%) typically develops in younger patients (<45) through the development of malignant low-grade astrocytoma (WHO grade II) or anaplastic astrocytoma (WHO grade III). The time required for tumor growth
The etiology of glioblastoma is unknown in many cases. Familial
glioma meet about 5% of malignant glioma, and less than 1% of glioma associated with genetic syndromes such as neurofibromatosis, Turcot syndrome or Li-Fraumeni syndrome.
ANATOMY
ma o t s a l b ) is Glio M B G ( rme multifo y brain r a m i r the p ith the w s r o an d e tum c n e d i t inc ive. s highes s e r g st ag the mo
DEFINITION
HO W t s te The la ation GBM IV fic classi as Grade fy classi toma y astroc
Etiology No definitive cause Believed to be result of genetic mutations that result in uncontrollable growth of specific types of brain cells Family hx accounts for <5% of causes for developing these tumors No direct linkage between lifestyle factors and malignant gliomas (alcohol, smoking, etc)
The Genetic Mutation Sparked GBM
Demographics -Overall
incidence is very similar among countries.
Glioblastoma multiformes are slightly more common in the United States, Scandinavia, and Israel than in Asia. -Glioblastoma multiforme is the most frequent primary brain Primary brain tumors are most tumor commonly found in older age -17,000 new cases of brain tumors diagnosed each groups year. 60% Covering 12-15% of intracranial GBM tumors Covering 50-60% of primary brain tumors The incidence of GBM will increase, especially the elderly. Morbidity depends on tumor location, progressiveness, and the effect of the pressure that appears.
The Incidence of Intracranial
Tumors
GBMs occur most often in the subcortical
white matter of the cerebral hemispheres. In a series of 987 glioblastomas from University Hospital Zurich, the most frequently affected sites were: temporal lobe (31%) parietal lobe (24%) frontal lobe (23%) occipital lobe (16%) Combined frontotemporal location is particularly typical. It is rarely seen in cerebellum or brain stem (may make up the remaining 6%)
Types about GBM
1. Primary, or de novo: tumor originates in brain tumors tend to form and present quickly. more common than secondary GBM (60% in adults older than 50) very aggressive tumors manifest de novo 2. Secondary: tumor cells metastasize to brain tumors have a longer, slower growth history, but still are very aggressive may begin as lower-grade tumors (grade II) or anaplastic astrocytoma (grade III) progression time varies
GBM Pathophysiology Tumor infiltration often extends into the adjacent cortex or the basal ganglia - signs & symptoms with basal ganglia pathology? Tumors in the frontal cortex can spread across the corpus callosum into the contralateral hemisphere, creating the appearance of a symmetric lesion, called a butterfly glioma.
Glial cell in the brain
provide nutrients and energy to neurons
astrosit oligodendrosi t mikroglia ependim
Glioma term used to
describe various types of malignancy that occurs in glial cells, both astrocytoma, oligodendroglioma and glioblastoma
Glioblastoma = astrositoma grade IV.
The types og glial cell
Clinical Manifestations aries depending on the size and location of the tumo The most common symptoms: Headache (80%) Seizure (30%) Neurological focal deficit (40- 60%) Mental status changes (2040%) Time of onset of symptom onset and diagnosis is usually <6 months
HISTOLOGY
The etiology is unknown
GBM
Genetic pathways in the development of GBM GBM De Novo (primer) In the group of elderly Overexpression of Epidermal Growth Factor Receptor (EGFR) PTEN mutations deletions p16INK4A
GBM Sekunder
The younger age group Evolving from a benign tumor malignant transformation TP53 gene mutations and retinoblastoma
DIAGNOSIS
DIAGNOSTIC EXAMINATION
TREATHMENT
MANAGEMENT Surgery maximum removal of tumor tissue is recommended if the tumor can be removed without causing the loss of certain functions Recommended Radiation performed 6 weeks after surgery with multiple fractions Admittedly radiation increases the life expectancy of up to 12-18 months. chemotherapy given during and after radiation for 6-12 months. Active Agents: Nitrosurea, Carmustine, lomustine. Alkilating agents: procarbazine, temazolamide, and vincristine
KOMPLIKA SI
PROGNOS IS
nekrosis radiasi, neuropati krn
kemoterapi Nitrosurea : mengakibatkan supresi myelum Komplikasi krn perjalanan penyakit rekurensi dan penyebarab leptomeningeal Angka harapa hidup rata-rata : 12 bulan 3-5% pasien bertahan > 3 tahun
Usia < 40 tahun : 18 msr 50 %
Usia 40-60 tahun : 18 msr 20 % Usia > 60 tahun : 18 msr 10 %
PENCEGA HAN
???
PROGNOSI S
THANKS YOU
DAFTAR PUSTAKA Ovedoff, David. 2002. Kapita Selekta Kedokteran Jilid 2. Binarupa Aksara. Jakarta. The Oncology Group. 2003. Cancer Management : A Multidiciplinary Approach. Oncology. News Interantional. New York. Curr Top Med Chem. 2005. 5(12) : 1151-1170. Combining Cytotoxic and Immune Mediated Gene Therapy to Traet Brain Tumors. Neuro-oncol. 2005. 10. 1215/S1152851704000584. Well-differentiated Neurocytoma : What Is The Best Avialable Treatment?
(9789004395114 - Reading Proclus and The < I> Book of Causes< - I> Volume 1) Reading Proclus and The < I> Book of Causes< - I> Volume 1 PDF
(9789004395114 - Reading Proclus and The < I> Book of Causes< - I> Volume 1) Reading Proclus and The < I> Book of Causes< - I> Volume 1 PDF
