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Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma - Gross Pathology | 5A0 Case 5 History
Case 5 History ---- In 1974 this patient had the onset of generalized tonic-clonic seizures. A CT scan showed a left temporal parietal avascular mass. In January of 1976 she underwent a left temporal craniotomy with a biopsy. of the temporal lobe tumor. The pathological diagnosis was anaplastic astrocytoma. Treatment was with 6,000 rads of radiation. Beginning 3 weeks prior to this admission her headaches increased in severity and she had problems with memory and developed a three day history of vomiting. An outside CT scan showed mass effect with areas of enhancement which included the subependymal lining of the lateral and 3rd ventricle. The diagnostic impression was that the patient had: a left temporal parietal frontal astrocytoma with possible transformation to glioblastoma. An EMI head scan performed in 2/14 showed a left sided frontal temporal lesion with ring enhancement. In addition, there was striking contrast enhancement of the entire ventricular system felt to represent subependymal extension of the neoplasm. A hematology-oncology consultant recommended protocol chemotherapy with high dose BCNU. For this reason she underwent bilateral posterior iliac crest bone marrow aspirations for bone marrow storage on 2/26/79. Following the bone marrow aspiration the patient became increasingly lethargic and confused. On the morning of 3/3 she was said to exhibit combative behavior. Because of "agonal respirations" she was intubated but her left pupil was fixed and dilated. Death was declared shortly thereafter from presumptive uncal herniation.
