{"id":"9a8bf5d7-d4a9-45d6-b642-7b7c2f0b1a16","slug":"hypervascular-glioblastoma-multiforme-or-arteriovenous-malformation-associated-glioma-a-diagnostic-and-therapeutic-challenge-a-case-report","title":"Hypervascular glioblastoma multiforme or arteriovenous malformation associated Glioma? A diagnostic and therapeutic challenge: A case report","authors":["Laura-Nanna Lohkamp","Christian Strong","Rafael Rojas","Matthew Anderson","Yosef Laviv","Ekkehard M. Kasper"],"abstract":"Background: Simultaneous presentation of arteriovenous malformation (AVM) and glioblastoma multiforme (GBM) is rarely reported in the literature and needs to be differentiated from “angioglioma”, a highly vascular glioma and other differential diagnosis such as hypervascular glioblastoma. Incorporating critical features of both, malignant glioma and AVM, such lesions lack a standard algorithm for diagnosis and therapy due to their rare incidence as well as their complex radiological and highly individualized clinical presentation. Case Description: We present a case of a 71-year-old female with newly developing motor deficits and radiographic findings of a heterogeneously contrast enhancing right-sided thalamic lesion with highly prominent vasculature. While computed tomography angiogram and cerebral digital subtraction angiography supported the diagnosis of AVM, contrast-enhancing magnetic resonance imaging (MRI) and MR-spectroscopy was suggestive of malignant glioma. A stereotactic biopsy revealed the diagnosis of a GBM (WHO IV) and the patient was treated accordingly. Conclusion: The coincidental presentation of vascular lesions such as AVM and malignant glioma is rare and presents a major challenge when establishing a diagnosis. The respective treatment decision is complicated by the fact that available treatment modalities (e.g. radiosurgery and/or open resection) carry disease specific complications for each entity. Finding a suitable solution for such cases requires standardization of early diagnostic and therapeutic management.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/9a8bf5d7-d4a9-45d6-b642-7b7c2f0b1a16/featured/hero-1782420835811.png","publishDate":"2016-11-21T00:00:00.000Z","doi":"10.4103/2152-7806.194506","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/9a8bf5d7-d4a9-45d6-b642-7b7c2f0b1a16/pdf"}