Glioblastoma multiforme in a case of acquired immunodeficiency syndrome: investigating a possible oncogenic influence of human immunodeficiency virus on glial cells

Case report and review of the literature

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✓ Malignant glioma is the most common primary brain neoplasm, but generally it is not included in the differential diagnosis of enhancing lesions of the central nervous system (CNS) in patients suffering from acquired immunodeficiency syndrome. We report a case of glioblastoma multiforme (GBM) in a 29-year-old man with human immunodeficiency virus (HIV). Primary CNS lymphoma was suspected, making a definitive histological diagnosis crucial. An initial stereotactic biopsy sample was insufficient to establish a diagnosis and a second biopsy of the lesion was obtained. The histopathological investigation confirmed GBM and adjuvant external radiation treatment was given to the patient, who survived for 4 months after the initial biopsy. A decline in the rate of Toxoplasma infection and the changing diseases observed in HIV infection indicate the importance of obtaining a biopsy in cases of CNS mass lesions.

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Address reprint requests to: Anil Nanda, M.D., Department of Neurosurgery, Louisiana State University Medical Center—Shreveport, 1501 Kings Highway, P.O. Box 33932, Shreveport, Louisiana 71130–3932.

© AANS, except where prohibited by US copyright law.

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Figures

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    Axial (left) and coronal (right) contrast-enhanced MR images of the brain illustrating the densely enhancing mass lesion, which is located in the region of the corpus callosum and involves the frontal lobes.

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    Upper: Medium-power photomicrograph of the tumor showing vascular proliferation, pleomorphic astrocytes, and extensive tumor necrosis. H & E, original magnification × 250. Lower: High-power photomicrograph of tumor showing pleomorphic astrocytes. H & E, original magnification × 400.

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    High-power photomicrograph of tumor immunostained against glial fibrillary acidic protein revealing large, distorted, irregular astrocytes. Original magnification × 400.

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