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Case #3

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Expand Physical Exam

10/18/XX

49-year-old woman presented with headache and episodes of mild disorientation over last 4 days, was found on the floor last night with R hemiparesis and severe confusion.

Expand X-Rays & Scans

10/18/XX

Brain MRI: There is a 5 x 4 x 3.2 cm irregularly enhancing mass in the L occipito-parietal region with extensive vasogenic edema and marked mass effect on adjacent brain.

Expand Operative Findings

10/22/XX

Grayish mass extends to the cortical surface and almost to the dura. Gross total resection of the tumor was performed, identifying a clear margin superiorly, laterally, inferiorly down to the tentorium and medially to the falx. Six BCNU wafers were placed against the edematous white matter.

Expand Pathological Reports

10/22/XX

Brain, L occipital region biopsy: glioblastoma.

10/22/XX

L occipital/parietal brain mass resection: glioblastoma multiforme (WHO grade IV).

Expand Treatment

10/22/XX

Surgery and Chemotherapy: L craniotomy with gross total resection of tumor and placement of BCNU chemotherapy wafers.

11/19/XX

Radiation: Started beam radiation to brain: 4500 cGy 6MV with boost 1620 cGy 6MV total dose 6120 cGy