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De novo glioblastoma in the territory of a recent middle cerebral artery infarction and a residual meningioma: pathogenesis revisited.

Yaghmour W, Kurdi ME, Baeesa SS - World J Surg Oncol (2016)

Bottom Line: We are reporting a 32-year-old male who developed left middle cerebral artery (MCA) infarction as a surgical complication for sphenoid meningioma.He developed recurrent symptoms 4 months later due to development of a glioblastoma adjacent to both the territory of the prior MCA infarct and the residual meningioma.This case adds further contribution to the literature of the possible pathological association between glioblastoma and brain infarction on a background of meningioma.

View Article: PubMed Central - PubMed

Affiliation: Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.

ABSTRACT

Background: The pathogenesis of glioblastoma is complex, and the implicated molecular mechanisms are yet to be understood. There are scattered reports describing a possible relationship between meningioma and glioblastoma and more rarely a relationship between infarction and glioblastoma.

Case presentation: We are reporting a 32-year-old male who developed left middle cerebral artery (MCA) infarction as a surgical complication for sphenoid meningioma. He developed recurrent symptoms 4 months later due to development of a glioblastoma adjacent to both the territory of the prior MCA infarct and the residual meningioma.

Conclusions: This case adds further contribution to the literature of the possible pathological association between glioblastoma and brain infarction on a background of meningioma.

No MeSH data available.


Related in: MedlinePlus

The extent of the infarction was demonstrated by FLAIR MRI sequence
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Fig2: The extent of the infarction was demonstrated by FLAIR MRI sequence

Mentions: A 32-year-old male first presented in January 2010 with a progressive headache for a 4-month duration. He was investigated with computed tomography (CT) and magnetic resonance imaging (MRI) scans that revealed large left sphenoid wing meningioma. He underwent left frontal craniotomy in a hospital at a neighboring country, for resection of the sphenoid wing meningioma. Brain swelling complicated the attempt of tumor resection; as a result, surgery was terminated after partial resection of the tumor. The patient had a complicated postoperative course with development of left middle cerebral artery ischemia causing aphasia and right dense hemiplegia. He was transferred to King Abdulaziz University hospital 3 weeks after surgery for further management. The pathology report from his referring hospital revealed that the tumor specimen of what has been resected was consistent with WHO grade I meningioma. On admission, he was conscious and alert but with marked expressive aphasia, upper motor right facial weakness, and power of grade 2 right-side hemiparesis. Routine laboratory investigation, including hematology, electrolytes, and renal and coagulation profiles, were within normal limits. MRI scans of the brain revealed significant residual meningioma of the left sphenoid wing meningioma (Fig. 1). There was a left cerebral infarction demonstrated on the fluid-attenuated inversion recovery (FLAIR) MRI scans (Fig. 2). The MCA was partially narrowed at the bifurcation; there was still significant tumor blood supply from the middle meningeal artery (Fig. 3). The patient was evaluated by the neurology team who started him on antiplatelet medication (aspirin, 80 mg daily) and advised delaying surgery 8–12 weeks to allow further recovery from stroke. He was transferred to the rehabilitation center where he received an extensive speech and physical therapy for 3 months with subsequent significant neurological improvement. He remained with only mild right-hand weakness of grade 3, and subtle word-finding difficulty, and an elective admission was planned for resection of the residual meningioma.Fig. 1


De novo glioblastoma in the territory of a recent middle cerebral artery infarction and a residual meningioma: pathogenesis revisited.

Yaghmour W, Kurdi ME, Baeesa SS - World J Surg Oncol (2016)

The extent of the infarction was demonstrated by FLAIR MRI sequence
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835844&req=5

Fig2: The extent of the infarction was demonstrated by FLAIR MRI sequence
Mentions: A 32-year-old male first presented in January 2010 with a progressive headache for a 4-month duration. He was investigated with computed tomography (CT) and magnetic resonance imaging (MRI) scans that revealed large left sphenoid wing meningioma. He underwent left frontal craniotomy in a hospital at a neighboring country, for resection of the sphenoid wing meningioma. Brain swelling complicated the attempt of tumor resection; as a result, surgery was terminated after partial resection of the tumor. The patient had a complicated postoperative course with development of left middle cerebral artery ischemia causing aphasia and right dense hemiplegia. He was transferred to King Abdulaziz University hospital 3 weeks after surgery for further management. The pathology report from his referring hospital revealed that the tumor specimen of what has been resected was consistent with WHO grade I meningioma. On admission, he was conscious and alert but with marked expressive aphasia, upper motor right facial weakness, and power of grade 2 right-side hemiparesis. Routine laboratory investigation, including hematology, electrolytes, and renal and coagulation profiles, were within normal limits. MRI scans of the brain revealed significant residual meningioma of the left sphenoid wing meningioma (Fig. 1). There was a left cerebral infarction demonstrated on the fluid-attenuated inversion recovery (FLAIR) MRI scans (Fig. 2). The MCA was partially narrowed at the bifurcation; there was still significant tumor blood supply from the middle meningeal artery (Fig. 3). The patient was evaluated by the neurology team who started him on antiplatelet medication (aspirin, 80 mg daily) and advised delaying surgery 8–12 weeks to allow further recovery from stroke. He was transferred to the rehabilitation center where he received an extensive speech and physical therapy for 3 months with subsequent significant neurological improvement. He remained with only mild right-hand weakness of grade 3, and subtle word-finding difficulty, and an elective admission was planned for resection of the residual meningioma.Fig. 1

Bottom Line: We are reporting a 32-year-old male who developed left middle cerebral artery (MCA) infarction as a surgical complication for sphenoid meningioma.He developed recurrent symptoms 4 months later due to development of a glioblastoma adjacent to both the territory of the prior MCA infarct and the residual meningioma.This case adds further contribution to the literature of the possible pathological association between glioblastoma and brain infarction on a background of meningioma.

View Article: PubMed Central - PubMed

Affiliation: Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.

ABSTRACT

Background: The pathogenesis of glioblastoma is complex, and the implicated molecular mechanisms are yet to be understood. There are scattered reports describing a possible relationship between meningioma and glioblastoma and more rarely a relationship between infarction and glioblastoma.

Case presentation: We are reporting a 32-year-old male who developed left middle cerebral artery (MCA) infarction as a surgical complication for sphenoid meningioma. He developed recurrent symptoms 4 months later due to development of a glioblastoma adjacent to both the territory of the prior MCA infarct and the residual meningioma.

Conclusions: This case adds further contribution to the literature of the possible pathological association between glioblastoma and brain infarction on a background of meningioma.

No MeSH data available.


Related in: MedlinePlus