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Vol. 23. Num. 5.September 2012
Pages 175-218
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Vol. 23. Num. 5.September 2012
Pages 175-218
DOI: 10.1016/j.neucir.2012.06.004
Multicentric glioblastoma multiforme. Report of 3 cases, clinical and pathological study and literature review
Glioblastoma multicéntrico. Descripción de 3 casos, estudio clinicopatológico y revisión de la literatura
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Andrea Arcosa, Lorena Romeroa,
Corresponding author
lorenaromeromoreno@gmail.com

Corresponding author. lorenaromeromoreno@gmail.com
, Ramón Serramitob, José M. Santínb, Antonio Prietob, Miguel Gelabertb, Miguel Ángel Arráeza
a Neurosurgery Service, Carlos Haya Regional University Hospital, Málaga, Spain
b Neurosurgery Service, University Hospital of Santiago, Santiago de Compostela, Spain
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Abstract
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Multicentric gliomas are uncommon lesions of the central nervous system. Their management remains controversial, but histopathologic diagnosis after complete or partial resection must be performed to differentiate these tumors from other multiple cerebral lesions. Three cases of multicentric glioma are presented, one of which had supra- and infratentorial lesions. Histological specimens were obtained from removal of at least one of the lesions. Neuropathological examinations confirmed the diagnosis of grade IV malignant glioma (glioblastoma). All 3 patients died soon after symptom onset. However, one patient, with metachronous glioblastomas, had a comparatively long survival. We discuss the pathogenetic hypotheses and the diagnostic problems, especially the differential diagnosis from other multifocal diseases of the central nervous system.

Keywords:
Multicentric gliomas
Glioblastoma multiforme
Multiple cerebral lesions
Infratentorial and supratentorial lesions

Los gliomas multicéntricos son lesiones inusuales del sistema nervioso central. Su manejo sigue siendo controvertido y es necesario un diagnóstico histopatológico tras su resección parcial o completa para diferenciarlos de otras lesiones cerebrales múltiples. Se presentan 3 casos de glioma multicéntrico, uno de ellos con lesiones supra e infratentoriales. Se obtuvieron muestras histológicas tras resección de al menos una de las lesiones. Análisis histopatológicos confirmaron el diagnóstico de glioma maligno grado iv (glioblastoma). Los 3 pacientes fallecieron en breve periodo de tiempo tras la aparición de los síntomas. Sin embargo, uno de ellos, con glioblastomas metacronos tuvo, comparativamente, una supervivencia algo más larga. Se discuten las hipótesis patogénicas y los problemas diagnósticos, especialmente el diagnóstico diferencial con otras lesiones multifocales del sistema nervioso central.

Palabras clave:
Glioma multicéntrico
Glioblastoma multiforme
Lesiones cerebrales múltiples
Lesiones supra e infratentoriales

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