A case of glioblastoma multiforme with long term survival: can we predict the outcome?
Glioblastoma Multiforme (GBM) presents a major challenge for a neurosurgeon as     the most common primary malignant tumour of the central nervous system. The     median life span after the diagnosis still remains between 6 months to 1 year     even after gross total excision of the tumour. However, few patients survive     long and develop recurrence after a substantial time interval. The exact reason     behind the long term survival in GBM cases remains obscure. However, few     predictors have been identified of late. Young age, p53 positivity,     O6-methylguanine methyltransferase (MGMT) methylation, aggressive surgical     resection and a good pre-operative Karnofsky Performance Score (KPS) have been     identified with good survival rates in these select cases. Immunohistochemistry     forms an integral part of a glioblastoma work up and it must be done in each and     every case as it may provide crucial insights regarding prognosis. We report a     rare case of glioblastoma multiforme with a long term survival of 20 years. This     patient developed a frontal cystic tumour bilaterally in these 20 years and is     still leading an active life. The clinical summary, imaging, histopathology,     immunohistochemistry along with relevant literature have been discussed.
Bombay Hospital Institute of Medical Sciences, Department of Neurosurgery, Mumbai, India. ashish_med@rediff.com
Ashish
A
Kumar
Chandrashekhar
C
Deopujari
Vikram
V
Karmarkar
D000328:Adult; D017668:Age of Onset; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography