Glioblastoma: Year of the Zebra

Watch video only
Glioblastoma multiforme, or simply glioblastoma, is a rare malignant brain tumor that typically affects adults; and is one of the most common and aggressive cancers of the central nervous system.Glioblastomas tend to be sporadic and arise from the uncontrolled growth of a certain type of glial cell called an astrocyte, within the central nervous system.
Glial cells help maintain the brain’s homeostasis and support neuronal function. Glioblastomas can be found throughout the brain and spinal cord, but are most commonly found in the cerebral hemispheres.
Now, the most common symptoms of glioblastomas are headaches, nausea, vomiting, and seizures, which occur as a result of the compression and destruction of healthy brain tissue.Depending on the location of the tumor, there can also be specific neurological deficits.
For example, involvement of the motor cortex can lead to muscle weakness; involvement of the sensory cortex can cause numbness or difficulty identifying objects through touch; involvement of the frontal lobe can cause personality changes; involvement of areas responsible for language can affect speech; and involvement of the visual pathway can lead to partial or full blindness.Since glioblastomas tend to be aggressive and grow quickly, they may cross from one cerebral hemisphere to the other through a bridge of white matter called the corpus callosum, giving the tumor the appearance of a butterfly on imaging.
As the tumor grows in size, it can compress nearby structures, interrupting their normal functions. For example, if the tumor blocks the flow of cerebrospinal fluid, it can cause an increase in intracranial pressure, or the pressure within the skull.
This is a dangerous complication that can lead to a fatal brain herniation. Generally, the diagnosis of glioblastomas involves imaging techniques like an MRI of the brain, which allows better identification of soft tissue structures like tumors.
Definitive diagnosis is made based on a tissue biopsy obtained through surgical removal of the tumor or a guided brain biopsy.
Tissue biopsy helps identify the unique molecular markers of each tumor and can help decide the most effective treatment.
Treatment of glioblastomas includes a combination of surgery, radiotherapy, and chemotherapy with agents like temozolomide.
Additionally, glucocorticoids like dexamethasone can be given to help minimize cerebral inflammation; and seizures can be treated with antiepileptic medications like levetiracetam.
Unfortunately, glioblastomas have a poor prognosis, with long-term survival rates remaining low even with current treatment.
A number of different treatments have shown promise in clinical trials and aim to achieve more durable responses in the future.
Alright, as a quick recap… A glioblastoma is a rare malignant brain tumor arising from glial cells and has an aggressive course with poor prognosis despite treatment.
Symptoms generally include a combination of headaches, nausea, vomiting, seizures, and neurological deficits. Diagnosis is made through imaging of the brain, with confirmation via tissue biopsy.
Treatment generally involves a combination