Department of Neuroradiology, Hospital Dona Estefania e Hospital São José, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
- Publicação sob a forma de poster electrónico no XVI Congresso da SPNR Diagnóstica e Terapêutica, 19 e 20 novembro 2021, Lisboa
- Neuroradiology volume 64, pages1047–1076 (2022); doi.org/10.1007/s00234-022-02903-2
Introduction: Glioblastomas are the most frequent primary malignant brain tumors in adults, albeit relatively rare in the pediatric age group. On imaging studies these tumors usually show thick and irregular contrast-enhancing margins surrounding a non-enhancing necrotic core, often with significant perilesional edema. Hemorrhagic foci may also be present and the solid components of the tumor may show restricted diffusion. The aim of this work is to review the imaging features of pediatric glioblastomas based on different cases from our institution.
Methods: Our prospective database of pediatric brain tumors was screened from January 2010 to June 2021. Pediatric patients (< 18 years old) with histologically proven glioblastomas were selected.
Results: Six patients were included, of which 4 were male and 2 female, aged 11 to 17 years. Three patients presented the usual imaging features of glioblastomas, showing both solid and necrotic components and displaying irregular contrast enhancement of the solid component. One case showed a large infiltrative T2- hyperintense lesion without contrast enhancement, resembling the gliomatosis cerebri imaging pattern. Another case displayed a regular and smooth ringenhancing lesion with a small mural nodule, mimicking a pilocytic astrocytoma, although peritumoral edema was seen. The last case showed a large T2-hyperintense lesion with a small area of restricted diffusion and mild smooth ring enhancement after gadolinium injection, without a clear necrotic core or surrounding vasogenic edema.
Conclusion: Glioblastomas are malignant tumors which may occur in all age groups, including the pediatric population. The presence of a diffuse infiltrating or focal spaceoccupying lesion with diverse imaging features in a pediatric patient should address the possibility of glioblastoma in its differential diagnosis.
Keywords: Children; Glioblastomas; MRI; pediatric brain tumors;