title: Sudden, unexpected death due to glioblastoma: report of three fatal cases and review of the literature.
abstract: Sudden death from an undiagnosed primary intracranial neoplasm is an exceptionally rare event, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series and only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to glioblastomas. We present three cases of sudden, unexpected death due to glioblastoma, with different brain localization and expression. A complete methodological forensic approach by means of autopsy, histological and immunohistochemical examinations let us to conclude for an acute central dysregulation caused by glioblastoma and relative complication with rapid increase of intracranial pressure as cause of death. Although modern diagnostic imaging techniques have revolutionized the diagnosis of brain tumors, the autopsy and the careful gross examination and section of the fixed brain (with coronal section) is still the final word in determining exact location, topography, mass effects and histology and secondary damage of brain tumor and contributed the elucidation of the cause of death. Immunohistochemistry and proteomic analysis are mandatory in such cases.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1218574899466985.
authors: Department of Forensic Pathology, University of Foggia, Ospedale C, D'Avanzo, viale degli Aviatori, 1, Foggia 71100, Italy.
authors: Irene
authors: I
authors: Riezzo
authors: Rosanna
authors: R
authors: Zamparese
authors: Margherita
authors: M
authors: Neri
authors: Francesco
authors: F
authors: De Stefano
authors: Ruggero
authors: R
authors: Parente
authors: Cristoforo
authors: C
authors: Pomara
authors: Emanuela
authors: E
authors: Turillazzi
authors: Francesco
authors: F
authors: Ventura
authors: Vittorio
authors: V
authors: Fineschi
mesh_terms: D000368:Aged; D001344:Autopsy / Q000379:methods; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D003645:Death, Sudden / Q000209:etiology*; D005909:Glioblastoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male
references: Histol Histopathol. 2011 Oct;26(10):1327-41
references: 21870336
references: Cancer. 1983 Dec 15;52(12):2313-9
references: 6640503
references: Cancer Res. 2004 Oct 1;64(19):6892-9
references: 15466178
references: Forensic Sci Int. 2006 May 10;158(2-3):200-3
references: 16191472
references: N Y State J Med. 1974 Sep;74(10):1832-4
references: 4528750
references: Am J Pathol. 2007 May;170(5):1445-53
references: 17456751
references: Cancer. 1993 Aug 1;72(3):856-69
references: 8334640
references: Int J Legal Med. 2005 Sep;119(5):280-4
references: 15864615
references: J Neurooncol. 2001 Mar;52(1):85-94
references: 11451207
references: J Neurooncol. 2000 Dec;50(3):239-43
references: 11263503
references: Childs Nerv Syst. 2002 Aug;18(8):440-4
references: 12192503
references: Acta Neuropathol. 2010 Nov;120(5):567-84
references: 20714900
references: Pediatr Neurosurg. 1996;24(1):35-40
references: 8817613
references: Clin Neuropathol. 1993 Jul-Aug;12(4):204-10
references: 8403630
references: Anticancer Res. 2006 May-Jun;26(3B):2463-6
references: 16821633
references: J Neuropathol Exp Neurol. 1998 Jul;57(7):684-9
references: 9690672
references: Neuro Oncol. 1999 Jan;1(1):44-51
references: 11550301
references: J Neurosurg. 1992 Sep;77(3):355-9
references: 1506881
references: J Neuropathol Exp Neurol. 2005 Jun;64(6):479-89
references: 15977639
references: J Neurosurg. 1995 Apr;82(4):548-57
references: 7897513
references: Acta Neuropathol. 2007 Aug;114(2):97-109
references: 17618441
references: J Neurosurg. 1986 Dec;65(6):751-5
references: 3772472
references: Cancer. 2000 Oct 1;89(7):1569-76
references: 11013373
references: Diagn Pathol. 2012 Oct 18;7:144
references: 23078815
references: Pediatr Neurosurg. 2000 Apr;32(4):214-9
references: 10940774
references: J Neurooncol. 1991 Apr;10(2):179-85
references: 1654403
references: Am J Forensic Med Pathol. 2010 Sep;31(3):278-80
references: 20606573
references: J Neurosurg. 2012 Aug;117(2):204-11
references: 22655594
references: Lab Invest. 2000 Jan;80(1):65-72
references: 10653004
references: Childs Nerv Syst. 2006 Mar;22(3):305-9
references: 16180045
references: Zentralbl Neurochir. 1981;42(4):241-50
references: 7340311
references: J Proteome Res. 2012 Oct 5;11(10):5011-21
references: 22909274
references: Am J Forensic Med Pathol. 1980 Mar;1(1):29-45
references: 6263083
references: J Neurosurg Sci. 2003 Sep;47(3):157-64; discussion 164-5
references: 14618129
references: Nihon Hoigaku Zasshi. 1993 Aug;47(4):336-9
references: 8397309
references: Arch Pathol Lab Med. 2001 Aug;125(8):1024-30
references: 11473451
references: Cancer. 2003 Aug 1;98(3):554-61
references: 12879473
references: Cancer. 1965 Jan;18:117-27
references: 14260073
references: Diagn Pathol. 2012 Jun 19;7:69
references: 22713481
references: Brain Pathol. 1996 Jul;6(3):217-23; discussion 23-4
references: 8864278
references: Childs Nerv Syst. 2003 Nov;19(10-11):729-35
references: 14631523
references: Brain Tumor Pathol. 2002;19(1):5-10
references: 12455882