Skip to main content Skip to main navigation menu Skip to site footer

Infiltrative multifocal glioblastoma progression in a twelve-year-old boy after COVID-19 infection: a case report

Abstract

Background: Glioblastoma is one of the most malignant types of primary central nervous system tumors with a high recurrence rate and dismal prognosis. Multifocal glioblastoma has been shown to have a poorer prognosis than solitary glioblastoma. Cancer patients are at risk of contracting COVID-19. It is hypothesized that COVID-19 may induce glioma tumorigenesis via angiotensin enzyme 2 receptor. We reported a rare pediatric multifocal glioblastoma in a twelve-year-old boy complicated with COVID-19.

Case Presentation: The patient was a twelve-year-old boy with a new-onset unprovoked seizure and headache. Magnetic resonance imaging (MRI) showed a heterogeneous solid cystic mass in the left temporal region (2.1x2.1x2.8 cm) with an increased choline/creatinine ratio and choline/n-acetyl acetate aspartate (NAA) ratio suggestive for high-grade glioma. The patient was contracting COVID-19 shortly after the diagnosis of glioblastoma. Two weeks later, patients came with significant neurological deterioration, hemiparesis, headache, and vomiting. MRI showed an infiltrative mass in the temporal and parietal region (5.05x8.03x8.3 cm) with intratumoral hemorrhage, also causing midline shift deviation (11.9 mm). The patient underwent trepanation and total safe resection of the tumor. Histopathological findings showed neoplastic cells with abundant mitotic figures, necrotic foci and pseudopalisading necrosis. These findings confirmed the diagnosis of multifocal glioblastoma.

Conclusion: Glioblastoma is a rare disease in the pediatric population with a poor prognosis due to its infiltrative nature and high recurrence rate. The patient had an acute deterioration of the neurological condition and rapid growth of the tumor after he contracted COVID-19, which may or may not be incidental. Further observation of similar cases will be required to determine the association between glioblastoma and COVID-19.

References

  1. Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012. Neuro Oncol. 2015;17 Suppl 4(Suppl 4):iv1-iv62.
  2. Song KS, Phi JH, Cho BK, Wang KC, Lee JY, Kim DG, et al. Long-term outcomes in children with glioblastoma. J Neurosurg Pediatr. 2010;6(2):145-9.
  3. Perkins SM, Rubin JB, Leonard JR, Smyth MD, El Naqa I, Michalski JM, et al. Glioblastoma in children: a single-institution experience. Int J Radiat Oncol Biol Phys. 2011;80(4):1117-21.
  4. Das KK, Mehrotra A, Nair AP, Kumar S, Srivastava AK, Sahu RN, et al. Pediatric glioblastoma: clinico-radiological profile and factors affecting the outcome. Childs Nerv Syst. 2012;28(12):2055-62.
  5. Ma J, Yin J, Qian Y, Wu Y. Clinical characteristics and prognosis in cancer patients with COVID-19: A single center's retrospective study. J Infect. 2020;81(2):318-356.
  6. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894-901.
  7. Herawati S, Kandarini Y, Mulyantari NK, Prabawa PY. Correlation of Neutrophil to Lymphocyte Ratio with Interleukin-10 in Diagnosis and Monitoring of Coronavirus Disease-19 Patients. Open Access Macedonian of Medical Sciences. 2022;10(B):63-66.
  8. Aldape K, Zadeh G, Mansouri S, Reifenberger G, von Deimling A. Glioblastoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 2015;129(6):829-848. doi:10.1007/s00401-015-1432-1
  9. Cage TA, Mueller S, Haas-Kogan D, Gupta N. High-grade gliomas in children. Neurosurg Clin N Am. 2012;23(3):515-523.
  10. Huang RY, Neagu MR, Reardon DA, Wen PY. Pitfalls in the neuroimaging of glioblastoma in the era of antiangiogenic and immuno/targeted therapy - detecting illusive disease, defining response. Front Neurol. 2015;6:33.
  11. Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963-72.
  12. Steffen-Smith EA, Shih JH, Hipp SJ, Bent R, Warren KE. Proton magnetic resonance spectroscopy predicts survival in children with diffuse intrinsic pontine glioma. J Neurooncol. 2011;105(2):365-373.
  13. Pervez W, Bakhshi SK, Mirza FA, Shamim MS. Management of paediatric glioblastoma. J Pak Med Assoc. 2021;71(1(B)):385-387.
  14. Singla AK, Madan R, Gupta K, Goyal S, Kumar N, Sahoo SK, et al. Clinical behaviour and outcome in pediatric glioblastoma: current scenario. Radiat Oncol J. 2021;39(1):72-77.
  15. Adams H, Adams HH, Jackson C, Rincon-Torroella J, Jallo GI, Quiñones-Hinojosa A. Evaluating extent of resection in pediatric glioblastoma: a multiple propensity score-adjusted population-based analysis. Childs Nerv Syst. 2016;32(3):493-503.
  16. Gupta S, Mallick S, Benson R, Haresh KP, Julka PK, Rath GK. Extent of surgical resection and adjuvant temozolomide improves survival in pediatric GBM: a single center experience. Childs Nerv Syst. 2017;33(6):951-956.
  17. Inggas MAM, Miskad UA, Islam AA, Wahjoepramono EJ, Maliawan S. Growth suppression of glioblastoma multiforme cell line response to the combination of Temozolomide and Nimotuzumab. Bali Medical Journal. 2021;10(3):1070-1075.
  18. Meinhardt J, Radke J, Dittmayer C, Franz J, Thomas C, Mothes R, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci. 2021;24(2):168-175.
  19. Daniels BP, Holman DW, Cruz-Orengo L, Jujjavarapu H, Durrant DM, Klein RS. Viral pathogen-associated molecular patterns regulate blood-brain barrier integrity via competing innate cytokine signals. mBio. 2014;5(5):e01476-14.
  20. Barrantes FJ. The unfolding palette of COVID-19 multisystemic syndrome and its neurological manifestations. Brain Behav Immun Health. 2021;14:100251.
  21. Yin XX, Zheng XR, Peng W, Wu ML, Mao XY. Vascular Endothelial Growth Factor (VEGF) as a Vital Target for Brain Inflammation during the COVID-19 Outbreak. ACS Chem Neurosci. 2020;11(12):1704-1705.
  22. Xu C, Wu X, Zhu J. VEGF promotes proliferation of human glioblastoma multiforme stem-like cells through VEGF receptor 2. ScientificWorldJournal. 2013;2013:417413.

How to Cite

Saputra, A., Bajamal, Z., Notopuro, F., & Puspitasari, L. D. (2022). Infiltrative multifocal glioblastoma progression in a twelve-year-old boy after COVID-19 infection: a case report. Intisari Sains Medis, 13(2), 475–479. https://doi.org/10.15562/ism.v13i2.1337

HTML
0

Total
0

Share

Search Panel