Pathology testing of the resected tumour confirmed it to be a Glioblastoma Multiforme (grade 4). The patient then went on to have surgical resection of the tumour with satisfactory results and was discharged from hospital a week after surgery. This is a world-first trial introducing pre-surgical medical therapy, consisting of a cocktail of medications, aimed at attacking the metabolic functioning of the tumour (the MAC study). The patient was entered into a new trial available through the NEWRO Foundation at the Wesley Hospital.
This test is not available at all institutions and we believe it is a critical to have this investigation available when following and treating patients with gliomas. In this case the FET-PET scan was positive, indicated by the area of increased activity (red mass in the corresponding area on this axial view. This is a functional test which is very specific for tumour and if positive, almost always indicates that the lesion seen on MRI does in fact represent recurrent glioma. Other tests are therefore required and this patient therefore went on to have a FET-PET scan.
Occasionally, "scar tissue" after radiation and chemotherapy can give a similar appearance. The diagnosis can be difficult to determine in these situations. Whilst it is very common, if not inevitable, that malignant gliomas will recur after standard therapy, and usually in the surrounding brain, the diagnosis at this point can be difficult to determine.įigures 1 and 2 show the MRI scans which suggest tumour recurrence (arrow). On routine follow up MRI scans, a new enhancing area adjacent to the resection cavity was identified. After his initial presentation with seizures, he had surgical resection of a small tumour of the right frontal region, and then this was followed with radiotherapy and chemotherapy. He had previously been treated at another institution after being diagnosed with a malignant glioma after suffering from seizures. A 48 year old man had been followed in our clinic for approximately 5 years.
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