Bone metastasis from glioblastoma: a systematic review

Strong, Michael J.; Koduri, Sravanthi; Allison, Jodi A; Pesavento, Cecilia M; Ogunsola, Sebele; Ogunsola, Oludotun; Yee, Timothy J; Khalsa, Siri Sahib S.; Saadeh, Yamaan S; Joseph, Jacob R.; Kashlan, Osama N.; Park, Paul; Oppenlander, Mark E.; Szerlip, Nicholas

doi:10.1007/s11060-022-04025-4

Cited by 13 publications

(28 citation statements)

References 87 publications

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“…Vertebral metastasis is exceedingly rare; to the best of our knowledge, there has been 59 cases reported in the literature ( Supplementary Tables 1, 2 ) ( 6 , 8 – 58 ). Mean age of the 59 patients is 43.9 years (range, 11-70 years), which is much younger than the average age of patients diagnosed with glioblastoma.…”

Section: Discussionmentioning

confidence: 99%

Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology

Matsuhashi

Tanaka²,

Takami³

et al. 2023

Front. Oncol.

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BackgroundGlioblastoma is a malignant tumor, and its prognosis is as poor as 1.5 to 2 years. Most cases recur within one year even under the standard treatment. The majority of recurrences are local, and in rare cases, metastasize mostly within the centra nervous system. Extradural metastasis of glioma is exceedingly rare. Here, we present a case of vertebral metastasis of glioblastoma.Case presentationWe present a 21-year-old man post total resection of the right parietal glioblastoma, diagnosed with lumbar metastasis. He originally presented with impaired consciousness and left hemiplegia and underwent gross total resection of the tumor. Given the diagnosis of glioblastoma, he was treated with radiotherapy combined with concurrent and adjuvant temozolomide. Six months after tumor resection, the patient presented with severe back pain, and was diagnosed as metastatic glioblastoma on the first lumbar vertebrae. Posterior decompression with fixation and postoperative radiotherapy were conducted. He went on to receive temozolomide and bevacizumab. However, at 3 months after the diagnosis of lumbar metastasis, further disease progression was noted, and his care was transitioned to best supportive care. Comparison on copy number status between primary and metastatic lesions on methylation array analysis revealed more enhanced chromosomal instability including 7p loss, 7q gain and 8 gain in the metastatic lesion.ConclusionBased upon the literature review and our case, younger age of initial presentation, multiple surgical interventions, and long overall survival seem to be the risk factors of vertebral metastasis. As the prognosis of glioblastoma improves over time, its vertebral metastasis is seemingly more common. Therefore, extradural metastasis should be kept in mind in the treatment of glioblastoma. Further, detailed genomic analysis on multiple paired specimens is mandated to elucidate the molecular mechanisms of vertebral metastasis.

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Section: Discussionmentioning

confidence: 99%

Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology

Matsuhashi

Tanaka²,

Takami³

et al. 2023

Front. Oncol.

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“…6 Although primary CNS tumors rarely disseminate outside of the CNS and leptomeninges, there have been reports of systemic metastasis in glioblastoma, oligodendroglioma, diffuse midline glioma, and others. 7,8 This patient underwent PET demonstrating hypermetabolic activity in the lower cervical spinal cord lesion and multiple vertebral and sacral bony lesions and 3 lumbar punctures without evidence of atypical or clonal cell populations on CSF flow cytometry and cytology.…”

Section: Sectionmentioning

confidence: 99%

Clinical Reasoning: A 22-Year-Old Man With Multifocal Brain and Osseous Lesions

Reddy,

Cha,

LaHue

2023

Neurology

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The evaluation of patients with disseminated processes with central nervous system and osseous involvement is often challenging. A 22-year-old healthy man developed left-sided weakness, paresthesias, and neck pain over several weeks. On clinical exam he was noted to have decreased right eye visual acuity, left-sided pyramidal weakness and numbness, and bilateral hyperreflexia. Magnetic resonance imaging (MRI) revealed multifocal widespread abnormalities: nonenhancing lesions throughout the infratentorial brain, pituitary gland, right frontal lobe, and optic nerves, in addition to an enhancing intramedullary cervical spinal cord lesion, extensive nodular leptomeningeal enhancement of the spine, and numerous enhancing bony lesions throughout the vertebrae and iliac bones. Cerebrospinal fluid (CSF) analysis was notable for normal opening pressure, protein 465 mg/dL, glucose 21 mg/dL, and normal cell count. Extensive serum and CSF analysis for infectious, inflammatory, and neoplastic etiologies was unrevealing, and the diagnosis was ultimately revealed after additional staining of tissue biopsy specimen from sacral and cerebellar biopsies. This case highlights the differential diagnoses for widely disseminated disease affecting the central nervous system and bones, and informs pediatric and adult clinicians of important recent developments regarding this diagnostic entity.

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“…Although the real incidence of extra-CNS metastases in GB is unknown, it is estimated, from the available series, that they occur in 0.5-2% of patients. The true incidence is probably higher since GB metastases are usually clinically silent and extracranial imaging is not commonly performed in these patients (6,10). Extra-CNS metastases from GB more commonly occur in lymph nodes (LN), lungs, pleura, soft tissues, glands, liver, and bone (10).…”

mentioning

confidence: 99%

“…The true incidence is probably higher since GB metastases are usually clinically silent and extracranial imaging is not commonly performed in these patients (6,10). Extra-CNS metastases from GB more commonly occur in lymph nodes (LN), lungs, pleura, soft tissues, glands, liver, and bone (10). Coca-Pelaz et al (11), recently conducted a systematic review of the literature published in the period 1944-2021, finding 174 cases of LN metastases from primary CNS tumors, with 52.8% being of glial origin.…”

mentioning

confidence: 99%

“…As this case and prior reports demonstrate, recurrent GB with extra-CNS metastases has very few treatment options. Exceptions to this rule are regional relapses such as those occurring in the dura and head and neck LN, or in oligometastatic bone metastases, which various reports have shown that may be subjected to local treatments achieving longer local and systemic controls (10,11,15,26). Considering that systemic therapy has not demonstrated to prolong OS in patients with recurrent GB, its management is even more complex in patients with extra-CNS metastases.…”

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confidence: 99%

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