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    Go to the top of the page   ID: 20020920100326 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Glioblastoma multiforme in a newborn
    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Carsten Bock, H. Hetschko, A. Jassoy (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Months  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    neoplastic  

     
     Pediatric Radiology CasesHistory:

    3 month-old infant. In the newborn-screening in an outside clinic, a echogenic - partly cystic - structure in the area ventral to the nucleothalamic groove was seen. This was judged as a finding after cerebral hemorrhage and was called for a follow-up examination in the 6th week of life. There were no other clinical signs.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    This is the most anaplastically modified form of glia cell tumors. Next to solid parts with increased mitotic nuclear morphology, one may see large-scaled necroses, cysts and hemorrhages. Commonly seen are edema around the area, however in this case none were seen.
    In scintigraphy or perfusional MRI, hyperperfunded. "Tangled" capillary appearance in angiography.
    Classification
    I.°: slow-growing, few mitoses, no endothelial proliferation.
    II.°: increased mitosis with polymorphic nuclei. No clear demarkation to healthy tissue.
    III.°: anaplastic Astrocytoma.
    IV.°: Glioblastoma multiforme. Cellular pleomorphism, vascular proliferation, mitoses and multi-nucleated giant cells.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Sonographic image of the tumor in coronal slice. About 57 x 35 x 42 mm mass with predominantly echogenic, but also areas of low echogenicity and cystic areas. Particularly the knees of the corpus callosum is not clearly distinguishable. The tumor is well-marcated caudally.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Sonographic image of the tumor in saggital slice. About 57 x 35 x 42 mm mass with predominantly echogenic, but also areas of low echogenicity and cystic areas




    MRI 1 <- view MRI 1

    MRI 1: T1 sagittal native: inhomogenic intensity with very hyperintense areas, which are hypointense in T2, and therefore are classified as hemorrhages. Cranially, you cannot distinguish the corpus callosum. Spans below the corpus callosum into both lateral ventricles.






    MRI 2 <- view MRI 2

    MRI 2: T1 coronal after contrast: An increased contrast media uptake in the tumor. Both lateral ventricles show compression.




    MRI 3 <- view MRI 3

    MRI 3: T1 before contrast application, transversal: Obvious widening of the lateral ventricles (right side more than left). Hemorrhage in the TM.




    MRI 4 <- view MRI 4

    MRI 4: T1 transversal, after contrast. obvious contrast uptake (compare to MRI 3).




    MRI 5 <- view MRI 5

    MRI 5: T2 transversal: The tumor grew into both lateral ventricles. There are cystic areas and areas of low signal (hemorrhage). Missing perifocal edema.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Other cerebral tumors. Due to the midline position and young age of our patient, a dysembryonal malformation tumor is assumed, which would also explain the missing edema. Furthermore, hemorrhaging with colliquation necrosis. Other tumors: metastases, lymphomas with hemorrhage and necrosis. Cerebral abscess with central necrosis.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    According to literature, glioblastoma multiforme makes up about 4 to 10% of pediatric intracranial tumors. In children, the sex ratio is the same (in other literature, 3:2 boys:girls) and the average age at the time of diagnosis is 9 to 10 years. The peak age lies, however, between the 35th and 60th year of life. In adults, glioblastomas make up about 15 to 30% of all cerebral tumors and is preferential to men in the ratio of 2:1.

    The preferred location lies frontally - followed by bifrontal, temporal, parietal, occipital and in the callosal region. The course is rapidly progressing. The first clinical signs are mostly headaches, focal seizures and changes in personality. Later, depending on location, cerebral pressure changes, neuroendocrinal changes and sleepiness.
    The primary treatment involves resection and radiation and/or chemotherapy. The prognosis is bad; the 5-year survival rate is under 5%. Only a third of the children survive the first year after diagnosis is made.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Glioblastoma multiforme, anaplastic glia cell tumor, anaplastic glioma, brain tumor, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: neoplastic
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Glioblastoma multiforme in a newborn
    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326


     

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    Glioblastoma multiforme in a newborn
    Other cases by these authors:

    Search Carsten Bock in Medline Carsten Bock (9)   
    Search H. Hetschko in Medline H. Hetschko (3)   
    Search A. Jassoy in Medline A. Jassoy (6)   

    Glioblastoma multiforme in a newborn  
     
    Glioblastoma multiforme in a newborn
    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326


     
     
    Glioblastoma multiforme in a newborn
    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326


     

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    Glioblastoma multiforme in a newborn
    Carsten Bock, H Hetschko, A Jassoy. Glioblastoma multiforme in a newborn. PedRad [serial online] vol 2, no. 9.
    URL: www.PedRad.info/?search=20020920100326


     




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