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Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma - Gross Pathology | 3A0 Case 3 History
Case 3 History ---- The decedent was a 54-year-old man with Factor V Leiden mutation, hemophilia and prior deep vein thrombosis managed with IVC filter, Xarelto and Plavix. At age 52 he developed seizures and glioblastoma. There was molecular analysis of IDH1 which was WT with MGMT promoter methylation. EGFR was amplified, and PTEN was lost, both genetic changes often seen in glioblastoma. He underwent resection in April 2013 followed by Temodar, radiation, and later treatment with Avastin, most recently two weeks before his final hospital admission. Brain MRI in September 2015 showed tumor progression and areas of hemorrhage; Xarelto and Plavix were stopped. He was found unresponsive in October 2015. Head CT showed a 4 cm acute intra-tumoral hemorrhage with increasing midline shift, subfalcine and uncal herniation, and entrapment of the right lateral ventricle. He continued to experience hemiparesis, dysarthria and dysphagia. Two weeks later, he was found unresponsive and it was decided to opt for comfort care and he died.
