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Overall Management
> Astrocytic
Tumors
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Journal of Neurosurgery: Pediatrics, December 2006 Volume 105 Number 6
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Abstract |
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Congenital glioblastoma
multiforme. Case report and review of the literature
Askin Seker and M.
Memet Ozek
Division of Pediatric Neurosurgery,
Department of Neurosurgery, Acibadem Neurological Sciences Hospital,
Istanbul, Turkey
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Congenital intracranial tumors are
rare.
If such a lesion is detected before birth,
it is usually an incidental finding on fetal ultrasonography.
The definition of a “congenital” tumor
is controversial.
The authors report the case of a
“definite” congenital glioblastoma multiforme (GBM) diagnosed with
the aid of ultrasonography and fetal magnetic resonance (MR) imaging
in the 37th week of gestation.
Postnatal MR imaging revealed a massive
tumor occupying the patient’s left temporoparietooccipital
area.
Angiography was performed to assess
vascularity and embolize the main feeding arteries.
Surgery was performed, and the tumor was
successfully excised completely.
The histopathological diagnosis of the
tumor was GBM.
An examination of the tumor cells revealed
no p53 accumulation, a high MIB-1 index (87.5%), and no staining for
epidermal growth factor receptor (EGFR).
Adjuvant chemotherapy was administered,
and the patient is doing well at 23 months of age.
Congenital GBM should be considered in the
differential diagnosis in cases in which a fetal ultrasonography study
or fetal MR image reveals a tumor, especially in the presence of
intratumoral hemorrhage.
Radical tumor removal, administration of
adjuvant therapy, and biological findings (such as a lack of the
overexpression of p53 and EGFR in the tumor cells) all point to a
longer survival time.
Keywords: congenital
glioblastoma multiforme, intratumoral hemorrhage, magnetic
resonance imaging, pediatric neurosurgery
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Copyright 2006 by American Association
of Neurological Surgeons
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Abstract
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