PMC9285856_01
Images of initial MRI examination and pathological diagnosis. (A) Magnetic resonance imaging revealed space-occupying lesion in medullary cone. (B) Hematoxylin and eosin stain of the resected tissue supported the diagnosis of glioblastoma (hypercellularity, nuclear pleomorphism, brisk mitotic activity and multinuclear giant cell). The immunohistochemical results showed that IDH1, GFAP, Oligo-2, p53, and S-100 were expressed and the Ki67 proliferation index was ~50%.
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Magnetic resonance imaging (MRI) showed a space-occupying lesion in the medullary cone (Figure 1A). Immunohistochemical results showed that the Ki-67 proliferation index was 50%. In addition, the tumor tissue stained positive for IDH1, GFAP, Oligo-2, Vimentin and S-100 (Figure 1B). In addition, the high ratio of p-AKT/AKT indicates that the AKT pathway is activated in the tumor cells (Supplemental Figure 1).
Dose distribution of three-dimensional conformal radiotherapy plan. Radiotherapy dose distribution is depicted as isodose levels. Planning target volume (PTV) is outlined in yellow.
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Three weeks after the surgery, the patient was treated with three-dimensional conformal radiotherapy (3D-CRT) for a total dose of 42 Gy in 21 fractions on August 26, 2020 (Figure 2).
Timeline of treatment and MRI responses. (A) Timeline of the patient's treatment. (B) MRI images of the patient at different times.
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The timeline of treatment and radiographic responses is shown in Figure 3.