GLIOBLASTOMA MIMICKING AN ABSCESS: A RADIO-PATHOLOGICAL CASE REPORT
ABSTRACT: Glioblastoma is an aggressive malignant glial neoplasm of the CNS with a dismal prognosis. It often presents as a ring enhancing lesion on imaging and if accompanied by abundant necrosis, it can often be misinterpreted as an abscess. Even on a histological examination, in the background of predominantly necrosis, the neoplasm might be missed without a thorough evaluation. This case had a similar presentation accompanied by an exuberant granulation tissue response mimicking an abscess, however no organism was found. A detailed radiological, pathological and microbiological evaluation is presented.
KEY WORDS: Glioblastoma; Abscess; Necrosis; Ring enhancing.
Ostrom, Q. T., Gittleman, H., Farah, P., Ondracek, A, Chen, Y, Wolinsky, Y. Barnholtz-Sloan, J. S. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006-2010. Neuro-oncology 2013;15, 2: ii1–ii56.
Jukich PJ, McCarthy BJ, Surawicz TS, Freels S, Davis FG. Trends in incidence of primary brain tumors in the United States 1985-1994. Neuro-Oncology 2001; 3,3:141–151.
I. R. Whittle, N. Basu, R. Grant, M. Walker, A. Gregor. Management of patients aged ≫60 years with malignant glioma: good clinical status and radiotherapy determine outcome, British Journal of Neurosurgery 2009; 16,4; 343-347.
Marijnen C.A, van den Berg S.M, van Duinen S.G, Voormolen J.H, Noordijk E.M. Radiotherapy is effective in patients with glioblastomamultiforme with a limited prognosis and in patients above 70 years of age: A retrospective single institution analysis. Radiother. Oncol. 2005; 75:210–216.
Roa W, Brasher P.M, Bauman G, Anthes M, Bruera E, Chan A., Fisher B., Fulton D., Gulavita S, Hao C. Abbreviated Course of Radiation Therapy in Older Patients with GlioblastomaMultiforme: A Prospective Randomized Clinical Trial. J. Clin. Oncol. 2004; 22:1593–1598.
Ping H. Lai, Jih T. Ho, Wei L. Chen, Shu S. Hsu, Jyh S. Wang, Huay B. Pan, Chien F. Yang. Brain Abscess and Necrotic Brain Tumor: Discrimination with Proton MR Spectroscopy and Diffusion-Weighted Imaging. American Journal of Neuroradiology 2002, 23,8: 1369-1377
Rong, Y, Durden, D. L, Van Meir, E. G, Brat, D. J. ‘Pseudopalisading’ necrosis in glioblastoma: a familiar morphologic feature that links vascular pathology, hypoxia, and angiogenesis. Journal of Neuropathology & Experimental Neurology 2006; 65,6, 529-539.
Ahn S H, Park H, Ahn Y H, Kim S, Cho M S, Kang J L, Choi Y H. Necrotic cells influence migration and invasion of glioblastoma via NF-κB/AP-1-mediated IL-8 regulation. Sci Rep. 2016; 6: 24552.
Kishore K, Beniwal M, Rao S, Rao K N, Vazhayil V, Srinivas D, Somanna S. Abscess within a Glioblastoma: Mimicking a Matryoshka Doll. World Neurosurg 2018; 113:146-152
To cite this article:
Malhotra A. Glioblastoma mimicking an abscess: a radio-pathological case report. Int. J. Med. Lab. Res. 2020; 5,2:69-72. http://doi.org/10.35503/IJMLR.2020.5208