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Case Report Open Access


Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment

Daniela Alexandru, Hung-Wen Kao, Mark Linskey, Ronald Kim, Anton N. Hasso, Daniela Bota.

Abstract
Glioblastoma multiforme (GBM) is the most common primary brain tumors, accounting for 15-20% of all intracranial tumors. It is one of the most lethal tumors of the central nervous system with a median survival from diagnosis on the order of 6 to 18 months. Despite aggressive resection and chemoradiation, the tumor always recurs. Magnetic Resonance (MR) imaging is an essential component in the diagnosis, treatment planning, and following response. However, the imaging features of recurrent GBM may be challenging, particularly in patients undertaking novel antiangiogenic therapy. We present such a case treated with repeated surgeries, combined chemoradiation, and bevacizumab. The patient benefited from the regimen with a 6-month progression-free survival, evidenced on both stable clinical condition and MR imaging findings. However, despite chemotherapy, a fulminant progression developed with growth multiple tumors in different locations and variable imaging characteristics, ranging from typical enhancing nodules to nonenhancing signal changes. The lesions of different imaging features were biopsy-proved to be recurrent GBM. We discuss the use of MR imaging in the evaluation of GBM treated with bevacizumab and emphasize the implication of signal abnormality on fluid-attenuated inversion recovery (FLAIR) images for early evidence of recurrence.

Key words: Glioblastoma multiforme, Bevacizumab


 
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How to Cite this Article
Pubmed Style

Alexandru D, Kao H, Linskey M, Kim R, Hasso AN, Bota D. [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. J Interdiscipl Histopathol. 2013; 1(4): 217-222. . doi:10.5455/jihp.20130328081943


Web Style

Alexandru D, Kao H, Linskey M, Kim R, Hasso AN, Bota D. [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. http://www.jidhp.com/?mno=34931 [Access: January 23, 2018]. . doi:10.5455/jihp.20130328081943


AMA (American Medical Association) Style

Alexandru D, Kao H, Linskey M, Kim R, Hasso AN, Bota D. [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. J Interdiscipl Histopathol. 2013; 1(4): 217-222. . doi:10.5455/jihp.20130328081943



Vancouver/ICMJE Style

Alexandru D, Kao H, Linskey M, Kim R, Hasso AN, Bota D. [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. J Interdiscipl Histopathol. (2013), [cited January 23, 2018]; 1(4): 217-222. . doi:10.5455/jihp.20130328081943



Harvard Style

Alexandru, D., Kao, H., Linskey, M., Kim, R., Hasso, A. N. & Bota, D. (2013) [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. J Interdiscipl Histopathol, 1 (4), 217-222. . doi:10.5455/jihp.20130328081943



Turabian Style

Alexandru, Daniela, Hung-Wen Kao, Mark Linskey, Ronald Kim, Anton N. Hasso, and Daniela Bota. 2013. [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. Journal of Interdisciplinary Histopathology, 1 (4), 217-222. . doi:10.5455/jihp.20130328081943



Chicago Style

Alexandru, Daniela, Hung-Wen Kao, Mark Linskey, Ronald Kim, Anton N. Hasso, and Daniela Bota. "[Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]." Journal of Interdisciplinary Histopathology 1 (2013), 217-222. . doi:10.5455/jihp.20130328081943



MLA (The Modern Language Association) Style

Alexandru, Daniela, Hung-Wen Kao, Mark Linskey, Ronald Kim, Anton N. Hasso, and Daniela Bota. "[Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]." Journal of Interdisciplinary Histopathology 1.4 (2013), 217-222. Print.. doi:10.5455/jihp.20130328081943



APA (American Psychological Association) Style

Alexandru, D., Kao, H., Linskey, M., Kim, R., Hasso, A. N. & Bota, D. (2013) [Recurrent Glioblastoma Multiforme: Implication of Nonenhancing Lesions on Bevacizumab Treatment]. Journal of Interdisciplinary Histopathology, 1 (4), 217-222. . doi:10.5455/jihp.20130328081943





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