gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Infratentorial glioblastoma in adults – experience in five patients

Meeting Abstract

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  • Nagi Massoud - Neurochirurgische Klinik, Klinikum Ingolstadt
  • Vera Koster - Neurochirurgische Klinik, Klinikum Ingolstadt
  • Siamak Asgari - Neurochirurgische Klinik, Klinikum Ingolstadt

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 021

doi: 10.3205/14dgnc416, urn:nbn:de:0183-14dgnc4160

Published: May 13, 2014

© 2014 Massoud et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Infratentorial manifestation of glioblastoma multiforme (GBM) is rare. Possible constellations are metastatic, multicentric, or primary manifestations in the infratentorial compartment. We want to present our experience and the evaluation of our results.

Method: This case study consists of a retrospective (single-center) analysis of 5 patients (3 males, 2 females) treated in our clinic between 2009 and 2013. Age distribution among this group is between 40 and 71 years. Considered were the location of the tumors, applied therapies (surgery, radiochemotherapy) and the clinical outcome of the patients. All operations were performed after oral 5-ALA application. Clinical and MRI examinations were performed in 3-months intervals. The patient with primary cerebellar GBM received CCTs only due to an implanted cardiac pacemaker.

Results: One patient with primary cerebellar GBM (variant A) underwent total surgical resection followed by adjuvant combined radiochemotherapy. Two patients developed a multicentric GBM with combined supra- and infratentorial involvement (variant B). One patient of variant B with brainstem participation exclusively underwent supratentorial surgery. The other patient of variant B underwent exclusively infratentorial surgery and received adjuvant radiochemotherapy. Two patients with primary supratentorial GBM (both underwent surgery followed by radiochemotherapy) developed infratentorial metastasis (variant C). One patient of variant C developed single cerebellar metastasis 12 months after primary temporal lobe resection and underwent tumor resection and secondary radiochemotherapy. The second patient of variant C with multiple metastatic infratentorial tumors in cerebellum and brainstem received a conservative management. The patient of variant A is still alive with no visible tumor (CCT) and enjoys an excellent quality of life, 7 months after primary diagnosis. Median survival time of both patients with variant B was 22.5 days. Median survival time of patients with variant C was 20 months.

Conclusions: Patients with primary cerebellar GBM (variant A) and patients with metastatic infratentorial GBM manifestation after supratentorial tumor resection (variant C) have considerably better outcomes and longer survival times than patients with multicentric combined supra- and infratentorial GBM (variant B). Microsurgery in patients with variant B seems to be very doubtful.