Cerebellar glioblastoma: a clinicopathologic series of 16 cases

Abstract

Due to their rareness, it is not known if the clinicopathological features of cerebellar glioblastomas (cGBMs) are different from supratentorial GBMs (sGBMs). We reviewed all 16 cases of cGBMs (total GBMs: 1350) at St. Michael’s Hospital over 18 years and assessed their clinicopathologic features. The mean age at diagnosis was 57 years. The most common presentations were headache (56%) and gait instability (56%). The majority (81%) of cGBMs were hemispheric while 19% involved the midline. There was radiologic evidence of brainstem infiltration at presentation in one case. Radiologically, peritumoral edema (63%) and heterogeneous contrast enhancement (50%) were common. Histologically, cGBM showed leptomeningeal involvement in 10/12 of cases. Uncommon histologic variants included 3 giant cell GBMs, a gliosarcoma, and a tumor with Rosenthal fibres and eosinophilic granular bodies. IDH1 R132H mutation was detected in 3/14 cases, a rate much higher than sGBMs. Additionally, 7/11 tumors had widespread p53 immunopositivity suggestive of TP53 mutation which is in accordance with previous reports in the literature. Of 9 cases tested, none had histone H3 K27M or G34R/V mutation. In summary, cGBMs have unique features that distinguishes them from sGBMs.LEARNING OBJECTIVESThis presentation will enable the learner to:1.Identify the clinicopathological features of cerebellar GBMs including major molecular alterations2.Compare cerebellar and supratentorial GBMs and describe the distinguishing features of each type of tumor