Open Access Case Report

Sudden, unexpected death due to glioblastoma: report of three fatal cases and review of the literature

Irene Riezzo1, Rosanna Zamparese1, Margherita Neri1, Francesco De Stefano2, Ruggero Parente1, Cristoforo Pomara1, Emanuela Turillazzi1, Francesco Ventura2 and Vittorio Fineschi1*

Author affiliations

1 Department of Forensic Pathology, University of Foggia, Ospedale “C. D’Avanzo”, viale degli Aviatori, 1, Foggia 71100, Italy

2 Department of Legal Medicine, University of Genova, via de’ Toni 12, Genova 16132, Italy

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Citation and License

Diagnostic Pathology 2013, 8:73  doi:10.1186/1746-1596-8-73

Published: 2 May 2013

Abstract

Sudden death from an undiagnosed primary intracranial neoplasm is an exceptionally rare event, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series and only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to glioblastomas. We present three cases of sudden, unexpected death due to glioblastoma, with different brain localization and expression. A complete methodological forensic approach by means of autopsy, histological and immunohistochemical examinations let us to conclude for an acute central dysregulation caused by glioblastoma and relative complication with rapid increase of intracranial pressure as cause of death. Although modern diagnostic imaging techniques have revolutionized the diagnosis of brain tumors, the autopsy and the careful gross examination and section of the fixed brain (with coronal section) is still the final word in determining exact location, topography, mass effects and histology and secondary damage of brain tumor and contributed the elucidation of the cause of death. Immunohistochemistry and proteomic analysis are mandatory in such cases.

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1218574899466985 webcite

Keywords:
Glioblastoma; Sudden death; Immunohistochemistry stains; Western blotting