Giant Cell Glioblastoma Associated with Intrinsic Arteriovenous Malformation

Background: Primary brain tumors associated with cerebral arteriovenous malformations (AVM) although known is a rarely reported finding. There have been approximately 50 cases reported. Only two cases of a single lesion with coexistence of AVM and glioblastoma were described. Case Report. We report a case of a 46-year-old woman with headache and seizures for 2 months who performed a MR which displayed a large right frontal lesion suggesting a glioblastoma. Results. During surgical resection, two large veins could be seen draining tumoral vascularization in the surrounding cortex. After reaching the deepest portion of tumor, veins were coagulated and cut to allow tumor removal. However, unexpected bleeding started to occur with associated lesion growth and edema, resembling an AVM. Material sent to pathology revealed giant glioblastoma in association to an AVM with some thrombosed vessels and ischemic necrosis. Two previous studies discussed similar cases. Conclusion. The need of magnetic resonance in all AVM cases is highlighted in order to analyze brain parenchyma within AVM. We also remark the need of pathological analysis of whole surgical material, in order to characterize whole piece and to avoid not diagnosingan associated lesion.