Glioblastoma associated with an arteriovenous malformation
Author(s): ,
J. Delaunois
UCL, Neurosurgical Department, Brussels, Belgium; CHR Namur, Neurosurgical Department, Namur, Belgium
J. Gonzalez
CHR Namur, Neurosurgical Department, Namur, Belgium
G. Milbouw
CHR Namur, Neurosurgical Department, Namur, Belgium
G. Koerts
UCL, Neurosurgical Department, Brussels, Belgium; CHR Namur, Neurosurgical Department, Namur, Belgium
EANS Academy. Delaunois J. 10/21/18; 226100; EP3070
Dr. Julien Delaunois
Dr. Julien Delaunois
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There are few reports in the literature concerning the association between glioblastoma (GBM) and arteriovenous malformation (AVM). We present a case of a GBM associated with an AVM and responsible of two hemorrhages.

Case report

A right-handed 58-year-old male patient was brought to the emergency department for an acute confused state with agitation. He was presenting symptoms of mesiotemporal epilepsy, like déjà vu episodes and olfactory hallucinations for six months. The cerebral CT-scan showed a right temporal hemorrhage and on angiographic sequences was identified a tangle of small vessels with an early venous drainage. A digital subtraction angiography was performed and does not show any vascular access authorizing a selective embolization. The patient was operated three weeks after the hemorrhage with a right temporal approach. The presumed vascular lesion was removed “en bloc” and there was no particular intraoperative finding, except a large thrombosed vein. Five days after the surgery, the patient presented a second hemorrhage requiring a reoperation.

Results and discussion

The anatomopathological analysis revealed the presence of astrocytic glial cells with some necrosis areas. There were also some vascular structures with angiomatous characteristics. Several hypothesis have been made about GBM associated with an AVM: fortuitous association, combined or sequential lesions. Another hypothesis is the development of the AVM due to the surexpression of vascular endothelial growth factor (VEGF) by the glioma.

We report a rare case of GBM associated with an AVM, illustrating the necessity to be aware about atypical hemorrhage locations and to perform in these cases a MRI to exclude a neoplastic lesion.
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