A 42-year-old woman presented with a 10-day history of headache accompanied by gait instability.
History of migraine, peripheral facial paralysis "frigore" for 20 years and episodes of depression.
Neurological examination showed right dysmetria and a positive Romberg maneuver and sequelae of facial paralysis.
Cranial computed tomography was performed finding an expansive process occupying posterior hemiblock dcha. The lesion had a solid component that was enhanced with the contrast product and a cystic component.
Brain magnetic resonance imaging confirmed the CT findings.
A 4 cm diameter lesion was found with a solid and cystic component surrounded by edema, located in the cerebellar hemisphere bucket.
This mass was heterogeneous and hypointense in relation to cerebellar tissue in T1 and hyperintense in T2.
He stood up with Gadolinium.
It was not accompanied by hydrocephalia.
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Surgery was performed with virtually total removal of the tumor through a posterior hemiblock resection.
The postoperative course was satisfactory and the patient was totally asymptomatic.
A follow-up brain MRI showed extensive resection of the tumor with minimal rest in the most cranial portion of the cerebellar hemisphere right next to the brainstem.
The pathological study diagnosed a glioblastoma multiforme (grade IV, WHO classification) with extensive areas of necrosis and consolidation.
Tumor cells showed nuclear immunohistochemical positivity for p53.
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Subsequently, the patient was treated with focal radiation therapy in the posterior fossa 60 Gy, 2 ICRU (Inter Cancer Care Committee on Radiation Units) concurrently with the European Organization for OATC 229 mg/m2 Research scheme).
Eight months after surgery, the patient remains asymptomatic, although control MRI shows the onset of tumor recurrence.
