title: Malignant glioblastomatous transformation of a low-grade glioma in a child.
abstract: BACKGROUND
  The term of low-grade glioma addresses a favorable clinical outcome with indolent histological features in general consideration; however, recent studies underline the inconsistency, which originates from the accumulation of different histologic subtypes in this terminology. The malignant transformation of a low-grade glioma is unusual but presents a poor prognosis.
  
  
  METHODS
  We report a case of a 12-year-old boy, who was referred for complaints of recurrent seizures. His physical examination was unremarkable, but it was learned that a peripheral mass lesion located on the left posterior parietal lobe--which had been thought to be a low-grade glioma--had been detected on a magnetic resonance imaging 2 years ago at a different hospital. The patient was then treated with valproate and carbamazepine for the seizures and advised to be followed up without any additional diagnostic and therapeutic studies for his suspected low-grade glioma. A recent magnetic resonance imaging study showed enlargements of the mass and surrounding edema with additional necrosis. Surgical excision of the tumor was performed. After the diagnosis of glioblastoma multiforme, the patient received radiation therapy and chemotherapy with a good clinical recovery without any evidence of residue or recurrence at 12-month follow-up.
  
  
  CONCLUSIONS
  The first line treatment modality in the management of low-grade glioma--especially in suitable patients--is clearly surgery. The gross total resection guarantees the distinguishing of the histological types of the low-grade gliomas and reflects the biologic behavior of these tumors. Observation without surgery must be reserved for selected inoperable cases.
authors.affiliation: Department of Pediatrics, Meram Faculty of Medicine, Selcuk University, 42080, Meram, Konya, Turkey. drekremunal@yahoo.com.tr
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Koksal
authors.forename: Omer
authors.initials: O
authors.lastname: Cimen
authors.forename: Yahya
authors.initials: Y
authors.lastname: Paksoy
authors.forename: Lema
authors.initials: L
authors.lastname: Tavli
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D005909:Glioblastoma / Q000473:pathology* / Q000628:therapy; D005910:Glioma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010296:Parietal Lobe / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery; D011379:Prognosis; D016896:Treatment Outcome