Glioblastoma

A glioblastoma or glioblastoma multiforme (GBM) is a highly invasive tumor of the central nervous system, primarily of the brain, and, more specifically, the cerebral hemispheres, basal ganglia, and commissural pathways. It is not curable with present methods, although recent developments have improved median survival. Onset is most common in the fifth or sixth decade of life, but certainly can appear in any adult or adolescent stage.

It is termed "malignant", which usually refers to the propensity to metastasize, but, as typical of central nervous system neoplasms, does not metastasize beyond the blood-brain barrier but expands rapidly within the central nervous system. GBM is the most common and aggressive primary (i.e., not from metastasis) brain tumor.

Diagnosis

Histopathology

It is a more pleomorphic and faster-growing form of astrocytoma, and is also called Grade IV astrocytoma. In addition to pleomorphism, the histopathology includes nuclear atypia, microhemorrhage, and necrosis. Margins are irregular and it is not encapsulated.

Treatment

While surgery has always been the core of treatment, prior to the use of adjuvant radiation and chemotherapy, it could only have a limited effect, as the irregular margins and infiltrating nature of the mass preclude complete removal, and indeed extensive debulking.