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Introduction
Glioblastoma multiforme (GBM) is an epithelial tumor of the central nervous system, which most commonly presents as a solitary lesion: The occurrence of multiple lesions is rare (1). GBM is most commonly occurs in individuals aged between 45 and 70 years old, with a worldwide incidence of 1–10% (1–3). The most common clinical symptom of GBM is epilepsy (1). Magnetic resonance imaging (MRI) is the primary diagnostic tool for GBM (4). Tumors involving the corpus callosum, which grow bilaterally into occipital and temporal lobes, result in a butterfly pattern on MRI, termed ‘butterfly glioma’ (5). Definitive diagnosis is based on histopathological examination of intraoperatively removed tumors/tumor sections. Morphological diagnosis is based on criteria defined by the World Health Organization (6,7). Surgical resection is recommended if feasible, followed by chemotherapy and radiotherapy, which is the standard treatment for GBM (8). GBM exhibits a highly unfavorable prognosis; The majority of patients only survive for 12–15 months following disease onset (9). Previous in vivo studies of GBM have focused on the etiology, pathology, clinical symptoms, imaging features, treatment and prognosis of the disease (1–3). In vitro studies of GBM cell proliferation have also been performed (10,11), however, the mechanism of disease progression and its corresponding MRI features remain unclear. In this study, a case of rapidly progressing GBM is presented, and the findings of MRI, surgical and pathological examinations are discussed. Written informed consent was obtained from the patient.
Case report
In April 2010, a 60-year-old male patient with mental confusion was admitted to The First Affiliated Hospital (Hangzhou, China) after experiencing convulsions for 1 day. Physical examination revealed that the pupil size of both eyes was equal; however, the pupillary light reflex was slow. In addition, high muscular tension of the limbs was observed and positive bilateral Babinski signs were identified. Blood examinations revealed a leukocyte count of 12.0×109/l and a neutrophil granulocyte level of 92.6%. Kidney function and blood gas composition were normal. MRI examination revealed abnormal signals from the temporal-occipital-parietal lobes and thus metastatic tumors were initially suspected and the possibility...