Cystic glioblastoma is a descriptive term for one form of glioblastoma that contains a large cystic component, rather than being a pathological subtype.
Please refer to the main article on glioblastoma for a broad discussion on this tumour.
The main challenge in discrimination between intracranial cystic lesions is to differentiate benign inflammatory cystic lesions (e.g. cerebral abscess) from malignant cystic lesions (e.g. cystic metastasis and cystic glioma) which have very different managements.
- well-defined intra-axial cystic lesion with peripheral ring enhancement
- usually presents with mass effect
- mild perifocal oedema
- enhancing margin and soft tissue component
- T1: homogeneously hypointense
- T1 C+ (Gd): enhancing margin and soft tissue component
- T2: hyperintense
- FLAIR: cystic areas show hyperintensity relative to CSF due to higher protein contents
- DWI/ADC: no restriction for the cystic component; the solid component may show restriction according to the grade
- MR spectroscopy: high Cho/Cr ratio
- MR perfusion: no appreciable perfusion changes are usually seen
Treatment and prognosis
Patients diagnosed with cerebral glioblastoma containing a large cyst survive longer and have a longer period before recurrence than those who lack such a cyst 1,2.
- 1. Maldaun MV, Suki D, Lang FF, Prabhu S, Shi W, Fuller GN, Wildrick DM, Sawaya R. Cystic glioblastoma multiforme: survival outcomes in 22 cases. Journal of neurosurgery. 100 (1): 61-7. doi:10.3171/jns.2004.100.1.0061 - Pubmed
- 2. Utsuki S, Oka H, Suzuki S, Shimizu S, Tanizaki Y, Kondo K, Tanaka S, Kawano N, Fujii K. Pathological and clinical features of cystic and noncystic glioblastomas. Brain tumor pathology. 23 (1): 29-34. doi:10.1007/s10014-006-0195-8 - Pubmed