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The enigma of multicentric glioblastoma: physiopathogenic hypothesis and discussion about two cases
Thiébaud Picart1, Marine Le Corre2, Emilie Chan-Seng2
1a Department of Neurosurgery , Lyon University Hospital-Hospices Civils de Lyon , Bron , France.
Abstract:
Two men were admitted following generalized seizures. Cerebral MRI-scans showed multiple independent enhancing lesions which were bilateral (first case) and unilateral but disseminated to the brainstem (second case). Whole-body CT-scans showed no primaries. Both cases were diagnosed by biopsy as IDH1 wild-type multicentric glioblastoma. Treatment of both was palliative. The natural history of this entity remains matter of debate but 2 genomic analysis strikingly revealed that foci from the same patient were of monoclonal origin. Consistently, these 2 cases could sustain the hypothesis that an anatomical connectivity exists between the different foci of a multicentric glioblastoma.
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