How Common Is Glioblastoma in Children?
Also known as glioblastoma, it is a common malignant neuroepithelial tumor of the central nervous system in adults, accounting for 22.3% of neuroepithelial tumors, and 10.2% of intracranial tumors have been reported.
- Chinese name
- Glioblastoma multiforme
- Foreign name
- glioblastoma multiforme, GBM
- Also known as glioblastoma, it is a common malignant neuroepithelial tumor of the central nervous system in adults, accounting for 22.3% of neuroepithelial tumors, and 10.2% of intracranial tumors have been reported.
Glioblastoma multiforme I. Etiology and common classification:
- GBM is derived from the malignant transformation of astrocytoma and is the most malignant type of astrocytoma. GBM is generally considered to be a progressive anaplastic manifestation of astrocytoma, mixed oligodendroglioma, and oligodendroglioma, as differentiated grade astrocytoma. The duration of this change varies, but can be quite short. Components with well-differentiated gliomas are called secondary glioblastomas, and those without well-differentiated gliomas are called primary glioblastomas. Primary GBM can be derived from a well-differentiated glioma that grows too quickly, or it can be derived from a Denovo primitive tumor with a stellate and oligodendrocyte differentiation tendency. Rare variant GBM can be divided into three types: giant cell glioblastoma, lipid-rich epithelioid glioblastoma, and gliosarcoma.
Glioblastoma multiforme II. Differential diagnosis:
- The clinical manifestations are mostly headache, convulsions and mental symptoms, etc. The tumor grows rapidly and is highly malignant, and the disease progresses generally faster. The average survival time is about 12 months. The cytological characteristics of GBM are that obvious necrotic lesions are seen in tumor tissue, surrounding tumor cells are arranged in a fence-like shape, and small blood vessels in the interstitial tissue are obviously proliferated like flower buds, glomeruli, or formed into curved long bands. Tumor cells often appear Polymorphism, easy to see heteromorphic multinucleated giant cells, often called pleomorphic glioblastoma. Immunohistochemical markers are often based on GFAP (+), vimentin (+) mostly indicates poor differentiation of tumor cells, and EMA and cytokine (CK) (+) mostly indicate tumor cell epithelial metaplasia. GBM is mainly located in the white matter of the cerebral hemisphere. It often invades the frontal, temporal, and parietal lobes, and the occipital lobe is rare. The basal ganglia and corpus callosum are often affected. Tumor tissue can invade the corpus callosum and grow on the contralateral cerebral hemisphere in an S-shape or through the corpus callosum In the deep part of the cerebral hemispheres on both sides, a butterfly shape grows, and GBM of the thalamus is not uncommon. Brainstem gliomas in children and young people mostly turn into GBM, GBM in the cerebellum is very rare. Due to the highly anaplastic and immature tumor cells, poor neovascularization, and thrombosis, there are often extensive degenerative bleeding and necrosis, so tumors are characterized by polymorphism.
- The growth characteristics of GBM: It can stretch to the deep along the nerve bundles in the white matter. For example, frontal tumors can grow along the frontal parietal tract to the ipsilateral parietal lobe, along the hook bundle to the ipsilateral temporal lobe, and can even grow along the corpus callosum to Contralateral cerebral hemisphere; Multicentric growth, 4.9% to 20% of GBM is composed of several seemingly independent tumor centers, each tumor center often clusters together, and satellite foci are sometimes seen near the tumor body.