Sudden death due to glioblastoma NOS: A rare medicolegal autopsy case report in Indian scenario

Even though the era has grown up into tremendous technological advances in health care, diagnosis of sudden death is still challenging.¹The definition of sudden death predominantly depends upon the duration and onset of symptoms.² According to the World Health Organization (WHO) and International Classification of Diseases, version 10 (ICD-10) sudden death is non-violent and not otherwise explained, occurring less than 24 hours from the onset of symptoms.³ There are several studies across the world that give ideas about patterns and profiles of cases of sudden death in relation to different age groups.^4–10 As mentioned in one of the studies, sudden deaths due to an undiagnosed primary intracranial neoplasm are exceptionally rare ones, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series. Out of which, only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to Glioblastomas.¹¹ The present case report describes the autopsy diagnosis of Glioblastoma NOS (Not Other wise Specified) in a case of sudden and unexplained death of a 40-year-old apparently healthy male.

A complete methodological forensic approach by means of autopsy, histological and immuno-histo-chemical examinations is important to label it a case of glioblastoma and relative complication with the rapid increase of intracranial pressure as the cause of death. Although modern diagnostic imaging techniques have revolutionized the diagnosis of brain tumors, the autopsy, careful gross examination, and section of the fixed brain (with coronal section) are still the final word in determining exact location, topography, mass effects, histology, and secondary damage of brain tumor and contributed the elucidation of the cause of death.