Glioblastoma multiforme en paciente anciano / Glioblastoma mutiforme in an old patient

ABSTRACT

Objective: to present a case report of glioblastoma multiforme in an elderly patient, simulating a brain abscess. Description a 79 year-old woman presented initially with facial cellulitis. 72 hours later, she developed mental status changes and language disorders. Neurological examination revealed disorientation, confusion, mixed dysphasia, dyslexia and writing disorders. CT and MRI sowed a mass lesion with midline shift, consistent with brain abscess. Intervention we performed a craniotomy, evacuation of the cystic lesion, drainage and biopsy of the wall cavity. The culture of sample obtained during surgery was negative. The pathology report corresponded to a glioblastoma. A reoperation was achieved for tumor removal. The postoperative course was favorable, without complications. Adjuvant radiochemotherapy was well tolerated. The clinical course was uneventful until 18 months postoperatively, when the patient had a generalized seizure and neurological deterioration. The MRI showed tumor recurrence. Despite support treatment and corticotherapy, a rapid progression to a comatose state and death occurred. Conclusion: glioblastoma multiforme should always be considered in the differential diagnosis of cerebral mass lesions in elderly patients. Clinical and radiological aspects may be similar to those of brain abscess. Agressive treatment should be postulated even in elderly patients with glioblastoma, who have a good performance status and acceptable operative risk.