Bilateral cystic glioblastoma multiforme

Abstract

Cystic glioblastoma multiforme (GBM) is a rare disease whose exact prevalence is unknown. Glioblastoma is usually seen as a unilateral solid tumor more commonly in the supratentorial compartment. The presence of cyst in the GBM is rare. Bilateral large cystic GBM is still rarer and we report such a case. An 83-year-old female was admitted with right hemiparesis and inability to speak for the last 4 days. There was no history of headache or seizures. On examination, there was increased tone on the right side with hemiparesis and aphasia. Magnetic resonance imaging revealed large enhancing cystic lesions measuring 4 × 2.8 × 3 cm and 4.5 × 4 × 3.5 cm in the right and left frontal regions respectively with surrounding edema [Figure 1]. Radiological possibilities suggested were glioma with differential diagnosis of abscess and metastasis. Burr-hole aspiration revealed hemorrhagic fluid and biopsy of the cyst wall confirmed the diagnosis of GBM. Attendants were explained the prognosis and did not give consent for definitive surgery. Patient died within 5 months of discharge from the hospital.