The craniotomy was reopened and a total macroscopic excision of the recurrence was performed. There was no evidence of tumor invasion of the dura or the bone flap. The dura was closed and the bone flap was replaced. The postoperative recovery was uneventful and the follow-up CT scan showed no evidence of residual tumor. Histology confirmed the diagnosis of a recurrent glioblastoma multiforme.
Brain tumor biopsy showing a glioblastoma multiforme.
There are clusters of pleomorphic and malignant giant cells. On examination, the patient was conscious but irritable. He had multiple nodules invading the scalp, as well as numerous hard cervical lymph nodes of variable sizes on both sides of his neck. CT scan of the brain demonstrated an extensive recurrence of the tumor which had invaded the left occipital lobe. Abdominal ultrasound was normal.