Rising Incidence of Glioblastoma Multiforme in a Well-Defined Population.

Background and Objectives The incidence of glioblastoma multiforme (GBM) ranges from 0.59 to 5 per 100,000 persons, and it is on the rise in many countries. The reason for this rise is multifactorial, and possible contributing factors include an aging population, overdiagnosis, ionizing radiation, air pollution and others. The aim of this study is to conduct an epidemiological study of GBM in a well-defined population over a 10-year period and determine its significance, while comparing results with international standards. Materials and Methods All histological diagnoses of GBM in Malta from 2008 to 2017 were identified. Poisson regression was used to determine significance in incidence variation. Log-rank tests were used to compare the survival distributions of each variable. Cox regression for survival analysis with the Breslow method for ties was then performed to consider the overall model. Results A total of 100 patients (61 males; mean age 60.29±10.09 years) were diagnosed with GBM over the period 2008 to 2017. There was a significant increase in incidence from 0.73 to 4.49 per 100,000 over the 10-year period (p≤0.001). The most common presenting complaint was limb paresis (29%). Approximately 65% of patients were treated with maximum safe resection (MSR). Using Cox regression analysis, younger age at presentation and treatment with MSR significantly improved survival (p=0.026 and p≤0.001, respectively). The median survival was 10 months. Conclusions An increasing incidence of GBM is becoming evident, while the median survival remains low. This troubling trend emphasizes the importance of further research into GBM etiology and treatment.

Multiple gliomas: a case review.

BACKGROUND: Multiple gliomas, although a rare finding, can present with a clinical and radiological picture similar to that of metastatic disease, abscesses, lymphoma and demyelination. CASE REPORT: We report a rare case of multiple gliomas located in the left cerebral hemisphere, with a complex presentation emulating other possible differential diagnoses. CONCLUSION: Multiple gliomas should be taken into consideration as part of the differential diagnosis of multiple parenchymal brain lesions. Certain imaging modalities and findings can be extremely valuable with obtaining a diagnosis, and the subsequent formulation of a therapeutic strategy.

Pattern of head injuries in Malta (EU): a small Mediterranean island.

We have reviewed all acute neurosurgical admissions between December 2007 and December 2009. Hundred and nine (46.6%) of our admissions were head injuries. A subdural haematoma(SDH) was found in 51.4%(56) of the head injuries. Of these, 50/56 presented with a Glasgow Coma Scale(GCS) of 14 to 15, 41.1% (23) of these SDH needed surgery. The commonest mode of injury was falls [67.9%(74) of head injuries]. Risk factors for falls are co-morbidities which are particular to an elderly population, these include osteoarthritis and audio/ visual impairment. Falls are more common in rural areas where elderly are more likely to feel comfortable to walk and sustain trivial falls resulting in chronic subdural heamatomas.

Chondromyxoid fibroma of the skull base invading the occipitocervical junction: report of a unique case and discussion.

Chondromyxoid fibroma (CMF) is a rare bone tumor representing less than 1% of total bone neoplasms. It is a slow-growing, locally destructive tumor that usually affects the metaphyseal region of long bones. The occurrence of this tumor in the skull base or cervical spine is exceptionally rare. We present the first case of CMF originating in the clivus and extending into the atlas and discuss the surgical management of this case.