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Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma - Gross Pathology | 8A0 Case 8 History
Case 8 History ---- The patient was a 66 year old female with a 2-6 week history of severe right temporal headaches which became progressively worse on the day of admission. A CT scan without contrast showed an area of decreased density in the right frontal area with compression of the frontal horn of right lateral ventricle and right-to-left midline shift including cingulate gyrus. A brain biopsy showed glioblastoma multiforme. Postoperatively she had a dense left hemiparesis and right gaze preference as well as a left Babinski sign. Her level of consciousness was initially improved, but at best she was oriented to person and date and had difficulty following commands. On postoperative day 13 she had a decreased level of consciousness associated with a low grade fever and stiff neck. CT scan showed a larger area of lucency with a larger area of rim enhancement within the corpus callosum as well as a larger right frontal lobe lucency with the same or possibly increased mass effect and shift compared with the preoperative scan. Radiation therapy was begun and she received 1800 rads. Nevertheless, she became progressively stuporous and eventually comatose. She developed bilateral Babinski signs, spastic quadriparesis. and non-reactive pupils. CT scan showed an increase in tumor mass. The decision was made to stop the radiation therapy . Supportive care was continued and she expired shortly thereafter.
