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MedenoSrce - Multiformni glioblastom

Multiformni glioblastom

Datoteke:
DatotekaVelikost
Snemi datoteko (gbm.ppt)gbm.ppt1595 kB


najpogostejši primarni možganski tumor
najmalignejši astrocitom
vrh pojavljanja med 45. in 60. letom
največkrat se pojavlja frontotemporalno

tumorske celice sledijo traktusom v belini možganovine

vrašča v duro

diseminacija po likvorju

Histološka slika
neovaskularizacija, krvavitve
nekroze, psevdopalisade
hipercelularnost
pleomorfizem jeder in citoplazme
Klinična slika
žariščni nevrološki znaki
zvišan ICP
hitro poslabšanje (krvavitev v tumor – apoplektični gliom)

Preiskave
stereotaktična biopsija
CT – heterogena lezija z obrobnim edemom
MRI – lokacija, velikost, stopnja edema
Zdravljenje
makroskopska popolna kirurška resekcija
radioterapija


3. kemoterapija
temozolomid (SU: mielosupresija, trombocitopenija, CD-4 selektivna limfocitopenija)
E: metilgvanin metiltransferaza (MGMT) – popravlja napake ―> inhibitorji
4. steroidna terapija



karmustinska polimerna plast
modificirane mišje celice z retrovirusnim vektorjem z genom za HSV timidinsko kinazo + ganciklovir
radiosenzitivno sredstvo + radiokirurgija
Prognoza
boljša pri gigantocelularnem GBM
1-letno preživetje 35 , 2-letno 10