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Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma - Gross Pathology | 29A0 Case 29 History
Case 29 History ---- The patient was a 54 year old female admitted to BJH in July 1979 for evaluation of papilledema and 3 intracranial masses. She had been doing well until one month prior to admission when while playing tennis she noticed that she was having some difficulty using her right arm. This difficulty however was only transient. Approximately 2 weeks prior to admission she had the onset of bifrontal headache which did not respond to simple analgesics. She was seen in the ER on 7/4/79 and at that time was noted to have blurred discs. She was admitted to Jewish Hospital. Workup there included a CT scan which showed 3 contrast enhancing mass lesions in the right frontal area, left parietal area, and left frontal area. Angiogram done on 7/17 showed 2 large vascular tumor masses, one in the right midfrontal area, and the second one in the interhemispheric fissure. She also had a smaller mass in the right parietal lobe. On 7/18/79 the patient had a CT guided needle biopsy of the right frontal tumor mass. Shortly after the needle biopsy the patient rapidly developed nausea and sweating, left hemiparesis, and within a period of minutes became hypertensive with a blood pressure of 210/120, dilated her right pupil with her left pupil being sluggish, and became unresponsive. She was given mannitol and steroids and taken immediately to the operating room for decompression, with a presumed diagnosis of herniation secondary to tumor hemorrhage. Postoperatively the patient was comatose with bilateral upgoing toes. Pupils were sluggishly reactive, with no doll's eyes and decorticate posture. There was no improvement in her neurological status until the time of death on 7/31/79 two weeks later.
