*Corresponding author:Walid Albanna, Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
Received: October 10, 2018; Published: October 22, 2018
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Glioblastomas tend to be morphologically diverse. Although rare, pseudoepithelial components (adenoid or epithelioid) can be a diagnostic challenge. We describe a case of a 47-year-old female patient initially complaining of neck pain and dizziness. On neurological examination, an unsteady gait and memory disturbances were noted. MRI showed a contrast-enhancing lesion in the left temporal lobe without significant edema, suggesting the presence of cerebral metastasis. After complete resection of the tumor (as verified by early post-op MRI), the patient made an uneventful recovery. Based on extensive histopathological analyses, the tumor was diagnosed as epithelioid glioblastoma (E-GBM). Two months after concomitant radiation and chemotherapy, the patient developed severe neck pain, became dizzy and was confused. CSF examination confirmed tumor cells, and MRI of the spine showed diffuse dural contrast enhancement, suggesting extensive leptomeningeal spread. The patient passed away four months after the initial diagnosis. E-GBMs represent one of the least prevalent morphologic subtypes of glioblastoma. Although E-GBMs are difficult to detect and often do not present as high-grade gliomas, clinicians should be aware of the unusual patterns of these GBMs. E-GBM should be considered in the case of MRI findings without peripheral edema, and when newly diagnosed intracerebral masses arise without a known primary. In addition, we discuss our case in terms of previous reports on this condition.
Keywords: Adenoid; Epithelioid Glioblastoma; Leptomeningeal; GBM
Abbreviations: E-GBM: Epithelioid Glioblastoma; EMA: Epithelial Membrane Antigen; GFAP: Glial Fibrillary Acidic Protein; MRI: Magnetic Resonance Imaging; CSF: Cerebrospinal Fluid; HE: Hematoxylin and Eosin