gms | German Medical Science

Questions: We report a fatal case of recurrent glioblastoma, in which neither intraoperative Alanin nor histopathology were able to demonstrate tumor growth. PET-CT was positive. Can operation be based on PET-CT findings alone ?

Case report: A 44 year old woman was treated for a glioblastoma of the right temporal lobe two years ago by operation and radiochemotherapy. Actually, a rapid neurological detoriation let to MRI-follow up, which revealed a tumor relapse of 70 cm³ . FET PET-CT visualized a clear uptake in 80% of the tumor volume. During the second operation, the tumor showed no alanin uptake. Due to postoperative, early MRI, 90% of the process had been removed. Histopathological examination did not confirm tumor growth, biochemical analysis of the spicemen was negative for gliobastoma specific markers . The patient improved for another 4 month and died with anew tumor progress due to MRI.

Conclusions: FET PET-CT was a highly specific modality for detecting recurrence in the glioblastoma reported and was effectively able to exclude post therapy changes. It was superior to histopathology, which has an impact on the indications for stereotactic procedures and intraoperativeinstantaneoussections. We propose a multicentre approach to collelct data systematically in order to compare the predictor qualities of PET-CT and histopathology.