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LETTER TO EDITOR
Year : 2004  |  Volume : 52  |  Issue : 1  |  Page : 130

Calcified occipital glioblastoma


Departments of Neurosurgery, Army Hospital (R & R), Delhi Cantt - 110010

Correspondence Address:
Departments of Neurosurgery, Army Hospital (R & R), Delhi Cantt - 110010
hsbhatoe@indiatimes.com



How to cite this article:
Bhatoe H S, Kumar H. Calcified occipital glioblastoma. Neurol India 2004;52:130


How to cite this URL:
Bhatoe H S, Kumar H. Calcified occipital glioblastoma. Neurol India [serial online] 2004 [cited 2019 Nov 19];52:130. Available from: http://www.neurologyindia.com/text.asp?2004/52/1/130/6730


Sir,
A rare case of a glioblastoma having areas of calcification is reported. The relevant literature is briefly reviewed.
An 18-year-old-boy was admitted with a one-month history of bifrontal headache, intermittent vomiting and diplopia. He had history of seizures since the age of four years. The seizures were not preceded by any aura and the ictus consisted of a blank expression lasting for a few seconds. His scholastic performance had been average. Clinical examination revealed bilateral abducens paresis and mild papilledema. There was right-sided homonymous hemianopia. There was no cognitive deficit, disconnection syndrome or motor weakness. Skull radiograph and CT [Figure - 1] done three years earlier had revealed calcification at the left occipital pole, without any mass effect. CT done at the time of present admission showed a large, mixed, attenuating and partly enhancing lesion at the left occipital pole having areas of calcification.
Left occipital craniotomy and a radical resection of the tumor-bearing occipital pole was carried out. The tumor was firm, solid and gritty and was not very vascular. The postoperative period was uneventful. Histopathology revealed a highly cellular tumor made up of anaplastic and pleomorphic cells with several mitotic figures and bizarre giant cells. Astrocytic proliferation was seen in the peripheral areas. There were areas of necrosis with palisading of nuclei and angioendothelial proliferation. Many areas of calcification were seen. The tumor was positive for glian fibrillary acid protein (GFAP). A diagnosis of glioblastoma multiforme with calcification was made. The lesion was then subjected to radiotherapy and chemotherapy. The patient was free from recurrence for three years after surgery, after which he was lost to follow-up.
Calcification may be seen in gliomas, especially in oligodendrogliomas and in mixed gliomas that have a benign histological appearance. It is unusual in high grade astrocytomas and glioblastomas; it is likely that some part of the previously low grade tumor may dedifferentiate into glioblastoma.[1],[2],[3],[4] Histological markers suggesting a better prognosis in gliobalstomas include presence of giant cells and differentiation. The presence of calcium deposits has rarely been recorded.[3] 

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1.Martin F, Lemmen LJ. Calcification in intracranial neoplasm. Amer J Pathol 1952:28:1107-31.  Back to cited text no. 1    
2.Anderson HC. Calcification process. Pathol Annual 1980;15:45-75.  Back to cited text no. 2  [PUBMED]  
3.Kubota T, Kogure Y, Yamamoto S, Matsubara S, Kitano T, Hayashi M. Calcification in glioblastoma multiforme of the cervical spinal cord. Surg Neurol 1986;26:183-6.  Back to cited text no. 3    
4.Wen PY, Fine HA, Black PM, Alexander E, Loeffler S. High grade astrocytomas Neurologic Clinics 1995;13:875-900.  Back to cited text no. 4    

 

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Online since 20th March '04
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