title: Cerebellar glioblastoma multiforme in an adult woman.
abstract: OBJECTIVE
  Glioblastoma multiforme (GBM) is the most frequent primary central nervous system malignancy in adults, accounting for 50% of all primary intracranial malignancies. GBM mostly arises within the cerebral hemispheres and frequently affects patients in the fifth and sixth decades of life. Conversely, primary cerebellar GBM is a rather infrequent occurrence in the adult population, accounting for 1%-2.2% of all GBMs. Here we report a case of cerebellar GBM in an adult woman and provide an extensive review of the literature.
  
  
  METHODS
  A 42-year-old woman was referred to our hospital for occipital constrictive headache, dizziness and gait disturbance. Multimodality imaging including computed tomography and magnetic resonance imaging (MRI) showed a right cerebellar mass. Gross total resection was performed. Histological examination showed grade IV GBM according to the World Health Organization classification, with a synchronous component of low-grade glioma. Immunohistochemistry showed positivity for p53 and negativity for epidermal growth factor receptor (EGFR). After surgical tumor excision, the patient underwent adjuvant radiation to the posterior fossa with an intensity-modulated approach for a total dose of 60 Gy in 30 fractions. In addition, she received concurrent and adjuvant chemotherapy with temozolomide.
  
  
  RESULTS
  Treatment was well tolerated, with mild acute toxicity. There was no evidence of recurrence on brain and spinal gadolinium-enhanced MRI scans 4, 8 and 12 months after primary surgery. No late side effects were recorded.
  
  
  CONCLUSIONS
  Our patient had several immunohistochemical characteristics of secondary glioblastoma such as p53 positivity, EGFR negativity and the presence of a low-grade glioma component. Intensity-modulated radiation therapy allowed us to safely deliver full-dose radiation with sparing of critical structures.
authors: Piera
authors: P
authors: Sciacero
authors: Giuseppe Franco
authors: GF
authors: Girelli
authors: Domenico
authors: D
authors: Cante
authors: Pierfrancesco
authors: P
authors: Franco
authors: Valeria
authors: V
authors: Casanova Borca
authors: Pierangelo
authors: P
authors: Grosso
authors: Annamaria
authors: A
authors: Marra
authors: Sebastiano
authors: S
authors: Bombaci
authors: Santi
authors: S
authors: Tofani
authors: Maria Rosa
authors: MR
authors: La Porta
authors: Umberto
authors: U
authors: Ricardi
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002528:Cerebellar Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004244:Dizziness / Q000209:etiology; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D005909:Glioblastoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006261:Headache / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D009682:Magnetic Resonance Spectroscopy; D060787:Neoplasm Grading; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53; D003606:Dacarbazine; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077204:Temozolomide