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WHAT IS IT?
Glioblastoma multiforme (GBM) is a very malignant primary brain tumor. It is also categorized as a grade IV astrocytoma because it is a malignant high grade tumor of astrocyte origin. It usually arises form the cerebral hemisphere.
WHY IS IT A PROBLEM?
This tumor will spread and can lead to death quickly.
WHAT MAKES US SUSPECT IT?
Risk factors: radiation therapy
Neurological signs/symptoms can include:
- Headache
- Seizures
- Cognitive changes
HOW DO WE CONFIRM A DIAGNOSIS?
MRI is the preferred initial imaging study for diagnosing this tumor radiologically. Findings of a heterogeneous, serpiginous contrast enhancing tumor is classic for GBM. The tumors are sometimes also described to have a “butterfly appearance” with central necrosis.
![Visual appearance of a glioblastoma on a T1 weighted MRI image (source)](http://www.stepwards.com/wp-content/uploads/2016/06/15381tn.jpg)
Histology will reveal malignant astrocytes that stain for GFAP and “pseudopalisading” pleomorphic tumor cells that border areas of necrosis and hemorrhage.
![Visual appearance of psuedopalisading tumor cells on a histological sample of glioblastoma (source)](http://www.stepwards.com/wp-content/uploads/2016/06/3b41085ffdaab2ea6d3488fe9055daaa.jpg)
HOW DO WE TREAT IT?
Surgical resection whenever possible.
HOW WELL DO THE PATIENTS DO?
Patients have a poor prognosis (median survival is ~ 1 year).
WAS THERE A WAY TO PREVENT IT?
N/A
WHAT ELSE ARE WE WORRIED ABOUT?
Metastases given how aggressive this tumor type.
OTHER HY FACTS?
Butterfly glioma: this malignancy can cross the corpus callosum and is referred to as a “butterfly glioma”.
![Gross histology depicting a "butterfly lesion" that crosses the corpus callosum (source)](http://www.stepwards.com/wp-content/uploads/2016/06/A2004-00287-GBM-Butterfly.jpg)
ARCHIVE OF STANDARDIZED EXAM QUESTIONS
This archive compiles standardized exam questions that relate to this topic.
FURTHER READING
Page Updated: 06.13.2016