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Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa.

Tomac D, Chudy D, Lambaša S, Topić I, Grahovac G, Zoric A - World J Surg Oncol (2011)

Bottom Line: The patient developed swelling of left temporal region, difficult swallowing and headache.MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa.The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia.

ABSTRACT

Background: Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck.

Methods: A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa.

Results: The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation.

Conclusions: The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

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Tissue sections showing a glioblastoma multiforme with bone invasion (hematoxylin-eosin stain, ×400)
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Figure 6: Tissue sections showing a glioblastoma multiforme with bone invasion (hematoxylin-eosin stain, ×400)

Mentions: Three months after operation control MSCT showed no signs of tumor. Eight months after the first operation MRI was performed and revealed a tumor that involved middle cranial fossa with extension to the left orbita, ethmoid and sphenoid sinuses, nasal cavity, and pterygomaxillar fossa (Figure 3, Figure 4). The patient had Karnofsky score of 70 at second admission when he was transferred to Department of Neurosurgery. Left temporal recraniotomy and reduction of intracranial tumor and tumor in pterygomaxillar fossa was performed. Zygoma and left side of the mandible were resected. Parotid gland and masseter muscle were used for defect reconstruction. Histological analysis showed glioblastoma multiforme with invasion of bone, muscles, and blood vessels (Figure 5, Figure 6 and Figure 7). The patient died two months after second operation. The patient and the family declined any other oncology treatment because the Karnofsky score at discharge was 40, which rapidly deteriorated after discharge form the hospital. Autopsy was not performed.


Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa.

Tomac D, Chudy D, Lambaša S, Topić I, Grahovac G, Zoric A - World J Surg Oncol (2011)

Tissue sections showing a glioblastoma multiforme with bone invasion (hematoxylin-eosin stain, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117736&req=5

Figure 6: Tissue sections showing a glioblastoma multiforme with bone invasion (hematoxylin-eosin stain, ×400)
Mentions: Three months after operation control MSCT showed no signs of tumor. Eight months after the first operation MRI was performed and revealed a tumor that involved middle cranial fossa with extension to the left orbita, ethmoid and sphenoid sinuses, nasal cavity, and pterygomaxillar fossa (Figure 3, Figure 4). The patient had Karnofsky score of 70 at second admission when he was transferred to Department of Neurosurgery. Left temporal recraniotomy and reduction of intracranial tumor and tumor in pterygomaxillar fossa was performed. Zygoma and left side of the mandible were resected. Parotid gland and masseter muscle were used for defect reconstruction. Histological analysis showed glioblastoma multiforme with invasion of bone, muscles, and blood vessels (Figure 5, Figure 6 and Figure 7). The patient died two months after second operation. The patient and the family declined any other oncology treatment because the Karnofsky score at discharge was 40, which rapidly deteriorated after discharge form the hospital. Autopsy was not performed.

Bottom Line: The patient developed swelling of left temporal region, difficult swallowing and headache.MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa.The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia.

ABSTRACT

Background: Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck.

Methods: A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa.

Results: The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation.

Conclusions: The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

Show MeSH
Related in: MedlinePlus