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DEPARTMENT OF HUMAN ANATOMY

FACULTY OF MEDICINE AHMADU BELLO UNIVERSITY ZARIA.

TOPIC ;

GLIOBLASTOMA MULTIFORME

BY:IBRAHIM ZULKIFILU MOHD.

SUPERVISOR: DR AA BURAIMOH

MARCH, 2015.

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Introduction• Definition: is the most common and most aggressive

malignant primary brain tumor in humans, involving glial cells and accounting for 52% of all functional tissue brain tumor cases and 20% of all intracranial tumors.

• The term "glioblastoma", also known as Grade IV Astrocytoma GBM is a rare disease which presents two variants: giant cell glioblastoma and gliosarcoma.

• Most glioblastoma tumors appear to be sporadic, without any genetic predisposition.

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Introduction cont’d• is the highest grade glioma (grade IV) tumor, is

the most malignant form of astrocytoma, and is synonymous with a grade IV glioma.

• The histologic features that distinguish glioblastoma from all other grades are the presence of necrosis (dead cells) and increase of blood vessels around the tumor.

• Affected patients have a uniformly poor prognosis with a median survival of one year .(osama Elzaafarani , 2014).

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Anatomy of the brain

This picture shows the major parts of the brain. (Image courtesy of the National Cancer Institute)

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Etiology of GBM

• The etiology of GBM is unknown in most cases. that is, No specific laboratory studies are helpful in diagnosing GBM, Suggested causes include the following:

Genetic factors.Cell phone use (controversial).Head injury or N-nitroso compounds, electromagnetic field exposure (inconclusive).occupational hazards.

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Classification of GBM 1, de novo (new or primary)

glioblastoma

• De novo tumors arise quickly and tend to make their presence known abruptly .

• they are the most common, and a very aggressive form of glioblastoma.

• De novo tumors account for the majority of glioblastomas in persons age 55 and older.

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A typical brain infected by glioblastomaCourtesy photo By,[ABTA] .

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2. Secondary glioblastoma • typically start as low-grade or mid-grade

astrocytoma which have been genetically programmed to eventually transform into malignant, rapidly growing glioblastoma.

• Secondary glioblastoma is most often

found in patients ages 45 and younger .

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Secondary glioblastoma

decnov

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Complications of GBM• Complications of glioblastoma multiforme include:

• Brain herniation• Coma• Inability to speak• Inability to swallow• Weakness or fatigue• Numbness• Side effects of chemotherapy• Side effects of radiation therapy

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Signs And Symptoms of GBM As a brain tumor grows, it may interfere with the

normal functions of the brain, Symptoms are an outward sign of this interference.

• Headaches, seizures, memory loss and changes in behavior are the most common symptoms.

• Loss in movement or sensation on one side of the body, language dysfunction and cognitive impairments are also common.

Signs And Symptoms of GBM

Photo courtesy of Jeffrey Bruce, MD .

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Contrast-enhanced MRI scan of aglioblastoma multiforme

                      

Glioblastoma (histology

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prognosis of GBM• This information is usually based on information gathered

from groups of people with the same disease.

• Younger adults and children tend to have a better prognosis Because these tumors often grow into surrounding tissue, and can be very difficult to treat. 

• For adults with the more aggressive glioblastoma, treated with concurrent temozolamide and radiation therapy, median

survival is about 14.6 months with a two-year median survival rate of 30%.

• 2009 study reported that almost 10% of patients with glioblastoma may live five years or longer.

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Risk factors of GBM

• Sex: male (slightly more common in men than women)

• Age: over 50 years old• Having a low-grade astrocytoma (brain tumor),

which often, given enough time, develops into a higher-grade tumor.

• Having one of the following genetic disorders is associated with an increased incidence of gliomas: Turcot syndrome, Tuberous sclerosis, Neurofibromatosis etc.

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Diagnosis for GBM

• personal and family health history .

• Neurologic examination.

• MRI and CT scan.

• Angiogram.

• Spinal tap.

• Biopsy i.e. Stereotactic biopsy.

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Treatment/Management of GBM

The treatment consists of both symptomatic and palliative therapies.• Symptomatic therapy's are; The primary supportive agents are

anticonvulsants and corticosteroids . The treatment focuses on relieving symptoms and improving the patient’s neurologic function.

• palliative therapy are; includes surgery, radiotherapy, gene therapy, radiation therapy, and chemotherapy.

treatment usually is conducted to improve quality of life and to achieve a longer survival time.

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Preventive Measures

There is no known way to prevent glioblastoma.

Some risk factors may increase a person's chance

of developing a brain tumor.

These include radiation therapy to the brain and

certain inherited disorders.

(National Institutes of Health (NIH), USA, 2011).

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Conclusion• Glioblastoma is based on the origin of primitive

precursors of glial cells (glioblasts), and the highly

variable appearance due to the presence of necrosis,

hemorrhage and cysts (multiform).

• As a brain tumor grows, it may interfere with the

normal functions of the brain and Symptoms are an

outward sign of this interference.

• Death is usually due to cerebral edema or increased

intracranial pressure.

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References References . ^ “A GUIDE TO Glioblastoma and Malignant Astrocytoma". American Brain Tumor Association (ABTA). Retrieved 4 September 2014. “Glioblastoma or glioblastoma multiforme • AM Omuro , Faivre S, Raymond E. Lessons learned in the development of

targeted therapy for malignant gliomas. Mol Cancer Ther. 2007;6:1909–1919. doi: 10.1158/1535-7163.MCT-07-0047. [PubMed] [Cross Ref]

• Fukumura D, Jain RK. Tumor microenvironment abnormalities: causes, consequences, and strategies to normalize. J Cell Biochem. 2007;101:937–949. doi: 10.1002/jcb.21187. [PubMed] [Cross Ref]

• High grade glioma standard of care and advance by osama Elzaafarani MARCH 2014.

• 2014 novel approach to glioblastoma treatment and ^ Stevens, Glen H. J. (2006). "Antiepileptic therapy in patients with central nervous system malignancies". Current Neurology and Neuroscience Reports 6 (4): 311–8. doi:10.1007/s11910-006-0024-9. PMID 16822352.

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