Glioblastoma is the most common and aggressive type of primary brain tumor. It arises from glial cells called astrocytes and is classified as a grade 4 astrocytoma. Common symptoms include persistent headaches, blurred vision, vomiting, mood changes, and seizures. Diagnosis involves neurological exams, CT/MRI scans, and biopsy. Treatment involves surgery followed by radiation and chemotherapy, though prognosis remains poor with average survival of 12-15 months after diagnosis.

1. GLIOBLASTOMA
Dr Hafiz Zayn Zafar

2. INTRODUCTION
• It is the more common name for a type of brain tumor that
arises from glial cells, specially astrocytes
• It is also called grade 4 astrocytoma, glioblastoma multiforme
and GBM4
• It can be primary (spontaneous growth) and secondary (evolve
from lower grade)
• It is the most aggressive and common type of primary brain
tumor which is common in males between 45-75 years

3. ASTROCYTOMA CLASSIFICATION
• Pilocytic Astrocytoma (Grade 1)
• Diffuse or Low Grade Astrocytoma (Grade 2)
• Anaplastic Astrocytoma (Grade 3)
• Glioblastoma Multiforme (Grade 4)
2-3 cases per 100,000 adults per year, 52% of all primary brain tumors

4. GROSS IMAGE

5. CAUSES AND RISK FACTORS
• Unknown cause (Mostly due to mutation)
• Neurofibromatosis
• Radiation Therapy
• Smoking
• Pesticides exposure
• Petroleum and Rubber Industry
• Sometimes associated with HHV6 and CMV

6. CLINICAL FEATURES
Depend upon size and location of tumor in brain. May be
asymptomatic in earlier period. Once symptoms start, condition
worsens quickly in next 2-3 months
• Persistent Headaches
• Blurred or Double Vision
• Vomiting ± Loss of Appetite
• Mood/Personality Changes
• Speech Difficulty
• Seizures
• Focal Weakness
• Changes in ability to think and learn

7. DIAGNOSIS
• Neurological Examination
• CT/MRI Scan
• Biopsy after Surgery
• Biomarker Analysis

8. PINK DRINK
Prior to surgery, patients in some
hospitals are given a drink containing
a substance called 5-ALA
(aminolevulinic acid). Often known as
the “pink drink”, even though it is not
pink, this causes the tumor cells in
the brain to glow pink under violet
light. This allows the surgeon to tell
the tumor cells apart from the normal
cells and so remove more of the
tumor. It has proven to be beneficial
for adults with high grade gliomas
such as glioblastomas.

9. TREATMENT DIFFICULTIES
• The tumor cells are resistant to conventional therapies.
• The brain is susceptible to damage from conventional therapy.
• The brain has a limited capacity to repair itself.
• Many drugs cannot cross the blood–brain barrier to act on the
tumor

10. TREATMENT
• Surgery (Mainstay)
• Radiotherapy
• Chemotherapy (Temozolomide)
• Anticonvulsants and Steroids (Supportive)

11. PROGNOSIS
• Survival 12 to 15 months after diagnosis
• Without treatment, only 3 months survival
• Cure extremely rare but reported
• Age>50 carries poor prognosis
• MGMT gene methylation promoter and IDH1 mutation have
better prognosis comparatively
• Death usually is due to widespread infiltration, cerebral edema
and raised intracranial pressure

12. THANKS
HEALTH IS WEALTH.