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Neurol Med Chir (Tokyo) ; 49(11): 532-5, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19940404

RESUMO

A 54-year-old man with Klinefelter syndrome presented with glioblastoma multiforme manifesting as a 2-week history of motor weakness of the bilateral extremities. Magnetic resonance imaging showed multiple heterogeneously enhanced tumors in the bilateral frontal lobes. Angiography showed no tumor stain or arteriovenous shunt. The tumor was partially removed through a right craniotomy. The histological diagnosis was glioblastoma. Immunohistochemical examination showed no O(6)-methylguanine-deoxyribonucleic acid methyltransferase protein expression. Postoperative local radiotherapy (60 Gy/30 fractions) combined with temozolomide (75 mg/m(2) x 42 days) and interferon-beta (3,000,000 U, 3 times/week) was performed. The patient's clinical status rapidly deteriorated during chemoradiotherapy, and he died of tumor progression 3.5 months after the surgery. Postmortem examination revealed widespread glioblastoma infiltrating the basal ganglia and thalamus. Klinefelter syndrome is associated with increased cancer predisposition, especially for male breast cancer and germ cell tumors, but glioma is extremely rare. The abnormal genetic constitution of this patient may have been directly responsible for the poor outcome.


Assuntos
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Glioblastoma/genética , Glioblastoma/patologia , Síndrome de Klinefelter/complicações , Síndrome de Klinefelter/genética , Gânglios da Base/patologia , Neoplasias Encefálicas/terapia , Craniotomia , Progressão da Doença , Tratamento Farmacológico , Evolução Fatal , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Predisposição Genética para Doença/genética , Glioblastoma/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Procedimentos Neurocirúrgicos , Paraparesia/etiologia , Radioterapia , Tálamo/patologia , Falha de Tratamento
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