Glioblastoma Multiforme Clinical Presentation

Updated: Jun 14, 2017
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS  more...
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Presentation

History

The clinical history of patients with glioblastoma multiformes (GBMs) usually is short, spanning less than 3 months in more than 50% of patients, unless the neoplasm developed from a lower-grade astrocytoma. Note the following:

  • The most common presentation of patients with glioblastomas is a slowly progressive neurologic deficit, usually motor weakness. However, the most common symptom experienced by patients is headache.
  • Alternatively, patients may present with generalized symptoms of increased intracranial pressure (ICP), including headaches, nausea and vomiting, and cognitive impairment.
  • Seizures are another common presenting symptom.
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Physical

Neurologic symptoms and signs affecting patients with glioblastomas can be either general or focal and reflect the location of the tumor. General symptoms include headaches, nausea and vomiting, personality changes, and slowing of cognitive function. Note the following:

  • Headaches can vary in intensity and quality, and they frequently are more severe in the early morning or upon first awakening.
  • Changes in personality, mood, mental capacity, and concentration can be early indicators or may be the only abnormalities observed.
  • Focal signs include hemiparesis, sensory loss, visual loss, aphasia, and others.
  • Seizures are a presenting symptom in approximately 20% of patients with supratentorial brain tumors.
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Causes

The etiology of glioblastoma remains unknown in most cases. Familial gliomas account for approximately 5% of malignant gliomas, and less than 1% of gliomas are associated with a known genetic syndrome (eg, neurofibromatosis, Turcot syndrome, or Li-Fraumeni syndrome). [1]

Although concerns have been raised regarding cell phone use as a potential risk factor for development of gliomas, study results have been inconsistent, and this possibility remains controversial. The largest studies have not supported cell phone use as a cancer risk factor. [42, 2, 3, 4, 5, 6] However, a recently released multinational report concluded that studies that are independent of the telecom industry show that cell phone use may pose a significant risk for brain tumors, [7] and some European countries have taken steps to limit cell phone use by children.

Studies of association with head injury, N-nitroso compounds, occupational hazards, and electromagnetic field exposure have been inconclusive. [42]

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