3. 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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4. 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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5. Anatomy of the brain
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This picture shows the major parts of the brain.
(Image courtesy of the National Cancer Institute)
6. 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:
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Genetic factors.
Cell phone use (controversial).
Head injury or N-nitroso compounds,
electromagnetic field exposure (inconclusive).
occupational hazards.
7. 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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8. 8
A typical brain infected by glioblastoma
Courtesy photo By,[ABTA] .
9. 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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11. 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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12. Signs And Symptoms of GBM
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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.
13. Signs And Symptoms of GBM
Photo courtesy of Jeffrey Bruce, MD
.
Contrast-enhanced MRI scan of a
glioblastoma multiforme
Glioblastoma (histology
14. 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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15. 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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16. 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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17. 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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18. 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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19. 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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20. 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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