J Korean Neurosurg Soc.  2017 May;60(3):380-384. 10.3340/jkns.2015.0303.006.

Primary Glioblastoma of the Cerebellopontine Angle: Case Report and Review of the Literature

• Lee JH
• Kim JH
• Kwon TH

• KMID: 2382776
• DOI: http://doi.org/10.3340/jkns.2015.0303.006

Abstract

Glioblastoma multiforme (GBM) is located most frequently in the cerebral hemispheres. Glioblastoma presenting as an extraaxial mass of cerebellopontine angle (CPA) is very rare in adults. We report a rare case of GBM arising in the CPA. The patient was a 71-year-old female, who complained of progressive gait disturbance and poor memory. Initial magnetic resonance imaging (MRI) revealed a 1.4×1.3 cm mass in the left CPA, with broad base to the petrous bone, showing homogenous enhancement. Follow-up MRI showed a rapid increase in size of mass (2.7×2.2 cm) with a necrotic portion. A stereotactic biopsy was done under the guidance of navigation system, and the histopathologic diagnosis was GBM, World Heath Organization grade IV. Further surgical resection was not performed considering her general condition, and the patient underwent concurrent chemotherapy with radiation therapy. Although rare, the possibility of glioblastoma should be included in the differential diagnosis of atypical CPA tumor.

Keyword

Glioblastoma multiforme; Cerebellopontine angle; Extraaxial

MeSH Terms

Adult
Aged
Biopsy
Cerebellopontine Angle*
Cerebrum
Diagnosis
Diagnosis, Differential
Drug Therapy
Female
Follow-Up Studies
Gait
Glioblastoma*
Humans
Magnetic Resonance Imaging
Memory
Petrous Bone

Figure

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  Fig. 1 Initial magnetic resonance imaging scans with axial enhanced T1-weighted (A) and T2-weighted (B) images, showing the mass in the left cere-bellopontine angle with broad base to the petrous bone (arrows).

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  Fig. 2 3 months-follow-up magnetic resonance imaging scans with axial (A) T1-weighted and T2-weighted (B) images reveal rapid increase in size of mass and extensive peritumoral edema (arrows).

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  Fig. 3 Magnetic resonance spectroscopy demonstrates an increased choline to creatine ratio, decreased N-acetyl aspartate, and increased lactate. This findings indicates the possibility of high grade tumor.

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  Fig. 4 A: Histopathology of the tumor shows atypical glial cells with frequent mitotic activity and moderate nuclear atypia (hematoxylin and eosin [H&E], 200×). B: Marked microvascular proliferation in the tumor (H&E, 200×). C: Immunohistochemical staining for GFAP reveals diffuse immunoreactivity in the tumor cells (200×). GFAP: glial fibrillary acidic protein.

Reference

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