Клінічний випадок гліобластоми у жінки 36-ти років

Abstract

На основі ретроспективного аналізу історії хвороби жінки 36 років та за результатами патологоанатомічного і гістологічного досліджень вивчалися особливості перебігу та структури гліобластоми лобової частки головного мозку в даної пацієнтки. Дані патологоанатомічного та гістологічного досліджень свідчать про розвиток у пацієнтки рецидивної гліобластоми лівої лобової частки головного мозку із проростанням у тверду мозкову оболону та стінку лівого бокового шлуночка, яка супроводжується периваскулярним та перицелюлярним набряком, повнокров’ям судин, некрозами, крововиливами, дифузною лімфолейкоцитарною інфільтрацією навколишньої мозкової тканини. Клінічний випадок підтверджує, що гліобластома головного мозку є злоякісною пухлиною, здатною до швидкого прогресування та розвитку рецидивів, характеризується тяжким перебігом, виникненням ускладнень та несприятливим прогнозом для життя пацієнта.; Glioblastoma is one of the most common tumors of the central nervous system, accounting for up to 62% of all astrocytic tumors. Glioblastomas are characterized by infiltrative growth and rapid development of clinical symptoms; incidence in men is higher (3:2 ratio). The tumor can be localized in any portion of the hemispheres, but most often in the frontal and temporal lobes. Notably, brain tumors rated third in the rise of morbidity among all cancer tumors. Despite all the advances introduced in contemporary medicine, the prognosis for patients with glial brain tumors remains extremely unfavorable. A high tendency to develop recurrences and metastases is a specific feature of the clinical course of malignant gliomas. 60-90% of patients experience recurrences (often at a distance of up to 2 cm from the primary tumor) and appearance of numerous foci after the treatment is possible in 5% of patients. Given the possible individual features of the disease, rapid progression and potential formation of metastases, each individual case of glioblastoma development should be carefully studied. Purpose. The paper is aimed at the analysis of the clinical course and morphological features of the left frontal glioma of the 36 year-old patient E. Object and methods. To gain the objectives of the research a retrospective analysis of the 36 year-old patient E. case history was made during which past medical history, findings of physical, laboratory and instrumental examinations were studied. To determine the morphological features of glioblastoma, postmortem craniotomy was performed and subsequent macroscopic analysis and sampling of material for histological study was carried out. Results and Discussion. Findings of the retrospective analysis of the 36 year-old patient E. case history showed that the disease was manifested by a recurrent headache. After a comprehensive medical examination, involving the brain magnetic resonance therapy and brain MRI with contrast, oncoscreening, she was referred to the Neurosurgical Department. On December 12, 2017, craniotomy was performed with total removal of the massive neoplasm of the left frontal lobe of the brain. The diagnosis of glioblastoma was histologically confirmed. Subsequently, the patient developed secondary meningoencephalitis, abscess of the frontal lobe of the brain, and aresorptive internal hydrocephalus. The diagnosis was made: Prolongatio morbid. Pronounced cerebral edema was. Plethora and parenchymal degeneration of the internal organs. Postmortem craniotomy revealed a neoplasm of the left frontal lobe of the brain with proliferation into the dura mater and the wall of the left lateral ventricle. Histological examination of the brain revealed perivascular and pericellular edema, plethora of blood vessels, areas of glioblastoma peripheral proliferation with large number of vessels, necrosis, hemorrhage, presence of hemosiderophages, diffuse lymphocytic infiltration. The findings of the analysis showed rapid progression of brain glioblastoma in the patient. After the final diagnosis was made her life expectancy was estimated in 1.5 year. The patient died within 6 months following the tumor recurrence. These terms correspond to the average ones and indicate unfavorable prognosis of this pathology.