Progressive multifocal exophytic pontine glioblastoma: a case report with literature review  

作　　者：Fanfan Chen Zongyang Li Chengyin Weng Peng Li Lanbo Tu Lei Chen Wei Xie Ling Li 

机构地区：[1]Neurosurgery Department,Guangzhou First People’s Hospital,Guangzhou Medical University,Guangzhou 510180,Guangdong,P.R.China [2]Neurosurgery Department,Shenzhen Second People’s Hospital,Shenzhen University,Shenzhen 518000,Guangdong,P.R.China [3]Oncology Department,Guangzhou First People’s Hospital,Guangzhou Medical University,Guangzhou 510180,Guangdong,P.R.China [4]Record Department,Guangzhou First People’s Hospital,Guangzhou Medical University,Guangzhou 510180,Guangdong,P.R.China

出　　处：《Chinese Journal of Cancer》2017年第7期326-334,共9页

摘　　要：Multifocal pontine glioblastoma exhibiting an exophytic growth pattern in the cerebello-pontine angle(CPA) is rare.We present a case of a 5-year-old girl with consecutive neurological imaging and other clinical findings indicating progressive multifocal exophytic pontine glioblastoma.Three lesions were reported,of which two were initially presented,and one was developed 2 months later.One lesion demonstrated a progressing exophytic extension in the cistern of the left side of the CPA.The other two lesions were located and confined within the pons.Initial magnetic resonance imaging and positron emission tomography-computed tomography indicated low-grade glioma or inflammatory disease.However,2 and 3 months later,subsequent magnetic resonance spectroscopy(MRS) displayed elevated choline and depressed N-acetyl aspartate peaks compared with the peaks on the initial MRS,indicating a high-grade glioma.Subtotal resection was performed for the CPA lesion.Histopathologic examination showed discrepant features of different parts of the CPA lesion.The patient received no further chemotherapy or radiotherapy and died 2 months after surgery.The multifocal and exophytic features of this case and the heterogeneous manifestations on neurological images were rare and confusing for both diagnosis and surgical decision-making.Our case report may contribute knowledge and helpful guidance for other medical doctors.Multifocal pontine glioblastoma exhibiting an exophytic growth pattern in the cerebello- pontine angle (CPA) is rare. We present a case of a 5-year-old girl with consecutive neurological imaging and other clinical findings indicating progressive multifocal exophytic pontine glioblastoma. Three lesions were reported, of which two were initially presented, and one was developed 2 months later. One lesion demonstrated a progressing exophytic extension in the cistern of the left side of the CPA. The other two lesions were located and confined within the pons. Initial magnetic resonance imaging and positron emission tomography-computed tomography indicated low-grade glioma or inflammatory disease. However, 2 and 3 months later, subsequent magnetic resonance spectroscopy (MRS) displayed elevated choline and depressed N-acetyl aspartate peaks compared with the peaks on the initial MRS, indicating a high-grade glioma. Subtotal resection was performed for the CPA lesion. Histopathologic examination showed discrepant features of different parts of the CPA lesion. The patient received no further chemotherapy or radiotherapy and died 2 months after surgery. The multifocal and exophytic features of this case and the heterogeneous manifestations on neurological images were rare and confusing for both diagnosis and surgical decision-making. Our case report may contribute knowledge and helpful guidance for other medical doctors.

关 键 词：BRAINSTEM Cerebello-pontine angle GLIOMA Multiple LESION PONTINE 

分 类 号：R739.41[医药卫生—肿瘤]