Glioblastoma Multiforme

Radiologic-Pathologic Correlation

Abstract Introduction Clinical Presentation Historical Perspective

Etiology and Genetics Pathologic Characteristics Radiologic-Pathologic Correlation

Therapy and Prognosis Conclusions Source Information References

Historical Perspective

In a brief footnote to their classic work, The Classification of Tumours of the Glioma Group on a Histogenetic Basis with a Correlated Study of Prognosis (1926), Harvey Cushing and Percival Bailey suggested that the term glioblastoma multiforme should replace previous terms such as spongioblastome unipolare and spongioblastoma multipolare, which had been used to describe the most common type of primary malignant brain tumor known at that time (11). The name GBM was initially intended by them to convey two basic facts about this malignancy: (a) It arose from the most primitive precursors of the supporting or stromal cell populations (glioblasts), and (b) its gross morphology was complex and highly variable (multiforme). Although their morphologic observations are still regarded as correct, current neuropathologic theory is that GBMs arise from the progressive dedifferentiation of mature cells, rather than from persistent embryonic cells or glioblasts. Frequently, this transformation occurs within a preexisting low-grade astrocytoma (12). Both genetic and histopathologic data support the concept of a stepwise increase in degree of malignancy from low-grade glioma to high-grade glioma, culminating in the GBM (13,14,15). Current research indicates that different genetic lesions are responsible for primary or de novo GBM, compared with secondary GBM that arises in a preexisting glioma (16).

Although the term glioblastoma multiforme is to some extent a misnomer, since the tumor does not arise from or contain glioblasts, its usage is too firmly rooted in modern clinical and neurosurgical practice to allow for correction. This usage may change if further advances in neuropathology give rise to more specific subcategories within this tumor group.

Abstract Introduction Clinical Presentation Historical Perspective

Etiology and Genetics Pathologic Characteristics Radiologic-Pathologic Correlation

Therapy and Prognosis Conclusions Source Information References