Analysis of a case of aircrew with gliomatosis cerebri

WANG Gaoqing; LIU Hongjin

Abstract：ObjectiveTo investigate the pathogenesis, diagnosis and treatment of aircrew with GC, to inquire into the relations of malignancy with flying and the criteria of individual aero medical evaluation.MethodsThe clinical data of 1case of aircrew with gliomatosis cerebri was analyzed and related literatures were reviewed.ResultsThe clinical manifestations were subacute onset. The initial symptoms and signs were not obvious, and the disease progresses more slowly. The patient fell down 4 times before pre hospital, which may be atonic seizures, and presented four different types of seizures, even found status epilepticusa in a day after admission. Seizures was the main characteristics of the patient. There was extensive head lesion in MRI, periventricular relatively symmetrical, and white matter was mainly involved, gray matter was also involved. There was no obvious enhancement. Intracranial infection, multiple sclerosis and other diseases were excluded. Brain biopsy was pathology of glioblastoma. Tumor cells by immunohistochemistry were GFAP(+++), Olig-2(+++), S-100 (+), MGMT(++). In view of comprehensive variety of factors, the patient was diagnosed as glioma disease. Temozolomide and bevacizumab were used to treat for six months, caused slower progression. Cancer caused the left lateral ventricle disappeared. The patient treated by core decompression had a poor prognosis.ConclusionThe clinical features of GC at early stage were obscure. The situation was more obvious in the aircrew because the health quality of aircrew is usually excellent before illness. Aviation physicians should raise the recognition level of the early features of GC so as to prevent wrong diagnosis. Aero medical assessment of flying personnel with malignancy should be evaluated according to clinical features, aircraft types and flight duties.