Endoscopy-verified occult subependymal dissemination of glioblastoma and brain metastasis undetected by MRI: prognostic significance

Although various prognostic indices exist for patients with malignant brain tumors, the prognostic significance of the subependymal spread of intracranial tumors is still a matter of debate. In this paper, we report the cases of two intraventricular lesions, a recurrent glioblastoma multiforme (GBM)...

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Bibliographic Details
Published inOncoTargets and therapy Vol. 5; pp. 449 - 456
Main Authors Iacoangeli, Maurizio, Di Rienzo, Alessandro, Colasanti, Roberto, Zizzi, Antonio, Gladi, Maurizio, Alvaro, Lorenzo, Nocchi, Niccolò, Di Somma, Lucia Giovanna Maria, Scarpelli, Marina, Scerrati, Massimo
Format Journal Article
LanguageEnglish
Published New Zealand Dove Medical Press Limited 01.01.2012
Taylor & Francis Ltd
Dove Press
Dove Medical Press
Subjects
Brain cancer
brain metastasis
Care and treatment
Case Report
Case studies
Diagnosis
Endoscopic surgery
Endoscopy
glioblastoma
Glioblastoma multiforme
Health aspects
Magnetic resonance imaging
Metastasis
minimally invasive surgery
NMR
Nuclear magnetic resonance
prognosis
subependymal spreading
Tumors
Italy
endoscopy
brain metastasis
glioblastoma
minimally invasive surgery
prognosis
subependymal spreading
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Summary:Although various prognostic indices exist for patients with malignant brain tumors, the prognostic significance of the subependymal spread of intracranial tumors is still a matter of debate. In this paper, we report the cases of two intraventricular lesions, a recurrent glioblastoma multiforme (GBM) and a brain metastasis, each successfully treated with a neuroendoscopic approach. Thanks to this minimally invasive approach, we achieved good therapeutic results: we obtained a histological diagnosis; we controlled intracranial hypertension by treating the associated hydrocephalus and, above all, compared with a microsurgical approach, we reduced the risks related to dissection and brain retraction. Moreover, in both cases, neuroendoscopy enabled us to identify an initial, precocious subependymal tumor spreading below the threshold of magnetic resonance imaging (MRI) detection. This finding, undetected in pre-operative MRI scans, was then evident during follow-up neuroimaging studies. In light of these data, a neuroendoscopic approach might play a leading role in better defining the prognosis and optimally tailored management protocols for GBM and brain metastasis.
ISSN:1178-6930
1178-6930
DOI:10.2147/OTT.S39429