Wounded glioma with fatal outcome: A report on biopsy of anaplastic glioma in two patients

Publication date: Available online 14 August 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Kara L. Krajewski, Silvia Hernández-Durán, Jakob Matschke, Tammam AbboudAbstractWe demonstrate two unusual cases of malignant swelling and rapid fatal outcome as a form of the “wounded glioma syndrome” after biopsy of diffuse anaplastic gliomas in two young men.In the first case, the lesion was throughout the right temporal, parietal and occipital lobes and extending into the basal ganglia with a small contrast-enhancing lesion in the temporal lobe. The patient underwent an open biopsy of the contrast-enhancing element. After an initial uncomplicated clinical course, he was increasingly lethargic on the fifth postoperative day; CT scan showed a massive increase in cerebral edema. Death occurred hours later. A diagnosis of oligodendroglioma WHO grade-III, IDH-mutant and 1p/19q-codeleted was made. In the second case, the lesion was in the frontal lobe extending to the basal ganglia without clear contrast enhancement. A frameless stereotactic biopsy was performed, and the patient could be discharged 5 days later. After two days, he was readmitted because of clinical deterioration. He suffered a grand-mal seizure resulting in a status epilepticus. After Intubation, an external ventricular drain was placed. Two hours later, a massive increase in intracranial pressure took place; CT scan showed signs of cerebral hypoxia. Death occurred the next day. A diagnosis of astrocytoma W...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research