PRIMARY GLIOBLASTOMA-MULTIFORME OF THE OCULOMOTOR NERVE - CASE-REPORT

Tumors of the oculomotor nerve are rare and most instances reported ha ve been schwannomas. The authors present clinical, neuroradiological, and neuropathological findings in a 70-year-old woman with a glioblast oma multiforme (GBM) growing primarily in the proximal part of the lef t oculomotor nerve. The patient presented with a I-month history of tr ansient diplopia. Neurological examination revealed an incomplete Left -sided oculomotor nerve palsy with no further signs of neurological dy sfunction. Cranial computerized tomography and magnetic resonance imag ing showed a tumor of the left oculomotor nerve without any obvious si gns of penetration into the midbrain or upper pens. Following subtotal removal of the tumor, neuropathological examination of the operative specimen revealed a GBM that had grown diffusely within peripheral ner ve tissue. Six weeks after surgery, the patient suddenly died of pulmo nary thromboembolism. Postmortem examination of the brain confirmed a large leptomeningeal GBM at the left pontomesencephalic junction with complete destruction of the left oculomotor nerve. To the authors' kno wledge, this represents the first case of a GEM of the oculomotor nerv e, probably originating from glial cells within the most proximal part of the nerve or the adjacent leptomeninges.