被殻出血にて発症したglioblastoma症例の診断遅延について

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  • Diagnostic delay of glioblastoma case with putaminal hemorrhage
  • ヒカクシュッケツ ニテ ハッショウ シタ glioblastoma ショウレイ ノ シンダン チエン ニ ツイテ

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<p>We experienced a case of glioblastoma with delayed diagnosis after onset of stroke due to relatively large cerebral hemorrhage. Then, we discussed the case of glioblastoma with cerebral hemorrhage with delayed diagnosis from previous reports. Our case is a man in his 70s. Untreated hypertension and hyperlipidemia were in the past history. He had left hemiparesis and dysarthria at home, and he was transported to our hospital 6 hours after the onset. On admission, CT showed the putaminal hemorrhage and midline shift. Because of deterioration of consciousness level, hematoma removal was performed for hypertensive intracerebral hemorrhage. 26 days after onset, his has improved and transferred to a recovery rehabilitation hospital. But even after 40 days, brain edema after intracerebral hemorrhage did not improve. At last enhanced MRI was performed, brain tumor was suspected. 50 days after onset, removal of tumor has performed, the final pathological diagnosis was glioblastoma, IDH-wild type (WHO grade IV). He has improved after radiation therapy and chemotherapy. Large hemorrhage of glioblastoma is rare, but early diagnosis and treatment are required for glioblastoma. Therefore, it is important to consider pathological diagnosis at the time of hematoma removal, and careful MRI and biopsy even in non-emergency cases.</p>

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