Extra Central Nervous System Metastases from Cerebral Glioblastoma Multiforme in Elderly Patients. Clinico-Pathological Remarks on our Series of Seven Cases and Critical Review of the Literature

Piccirilli, Manolo; Brunetto, Giacoma Maria Floriana; Rocchi, G; Giangaspero, Felice; Salvati, Maurizio

doi:10.1177/030089160809400109

Cited by 82 publications

(89 citation statements)

References 62 publications

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“…In 1969, it was reported that 0.44% of patient developed extracranial metastatic GBM [28]; more recently it is thought that the frequency may be as high as 2% [20]. From our literature review, the majority of patients with metastatic GBM were reported after 1980.…”

Section: Discussionmentioning

confidence: 80%

“…Hematogenous seeding may occur during surgery or if there is vascular invasion from the tumor. Using the former hypotheses, it would be expected that the greater the resection the more likely the risk but three reported cases had only a biopsy, suggesting vascular invasion may be a feasible explanation [18] [20]. Lymph nodes were among the most frequently metastasized sites.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic glioblastoma: case presentations and a review of the literature

et al. 2011

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Extracranial metastases from glioblastoma (GBM) are uncommon with an estimated incidence of less than 2%. We report two cases of metastatic GBM seen within an 8-week period followed by a literature review. We attempted to identify common factors or a causative mechanism. Factors that predominated among the reviewed cases included male gender, tumor location, and younger age. Causative mechanisms were not apparent. While metastatic disease remains rare, it might be occurring with increasing frequency. This trend might be due to increased diagnosis, better imaging, a more extensive physician workup, or an increase in survival. Metastatic GBM can present and progress quite rapidly, and repeat evaluations of persistent or worsening complaints among GBM patients are warranted. Early diagnosis of metastatic disease spread can help to expedite alleviation of patients' discomfort, in an already aggressive disease process.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Metastatic glioblastoma: case presentations and a review of the literature

et al. 2011

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“…Despite advances in surgical, medical and radiation therapies, the mortality of GBM remains high, with a median survival ranging between 40 and 70 weeks (2). Like other primary brain tumors, the extracranial metastasis of GBM is extremely rare, occurring in <2% of all GBMs (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Extracranial metastasis of gliobastoma: Three illustrative cases and current review of the molecular pathology and management strategies

Ray

Manjila

Hdeib

et al. 2015

Molecular and Clinical Oncology

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Abstract. Glioblastoma (GBM) is the most common and the most malignant primary brain tumor in adults, accounting for ~12-15% of all intracranial neoplasms. Despite advances in surgical, medical and radiation therapies, the mortality of GBM remains high, with a median survival ranging between 40 and 70 weeks. Similar to other primary brain tumors, the extracranial metastasis of GBM is extremely rare, occurring in <2% of patients. To demonstrate the clinical characteristics of this rare tumor, we herein present three cases of extracranial GBM metastasis: One to the lungs, which represents the longest reported survival of lung metastases from GBM to date; the second to the soft tissue of the posterior neck; and the third to the lumbar intradural space. Unlike tumors elsewhere, there are unique barriers in the brain that prevent the hematogenous and lymphatic spread of intracranial tumors, such as the dura mater and the thickened basement membrane of the blood vessels. In addition, central nervous system tumor cells lack extracellular matrix proteins required to invade surrounding connective tissue, a prerequisite for tumor dissemination. In this study, we aimed to investigate the different possible mechanisms underlying the extracranial metastasis of GBM and determine the biomolecular and genetic characteristics differentiating GBMs that metastasize from those that do not. We also reviewed the role of systemic chemotherapy and bevacizumab in the treatment of disseminated GBMs. Early identification and differentiation of these tumors may enable patients to benefit from surgical resection, radiation and combination chemotherapy prior to developing other comorbidities from metastatic disease, which may translate into prolonged survival with an acceptable quality of life.

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“…Glioblastoma multiforme is the most common and most malignant of primary brain tumors [1]. Despite the highly locally invasive nature, this tumor has a low potential to metastasize outside the conWnes of the CNS [113]. The occurrence of extracranial metastases is a very uncommon event with a reported frequency of less than 2%, although this has increased in recent years as patients survive longer [124].…”

Section: Discussionmentioning

confidence: 99%

A survey of metastatic central nervous system tumors to cervical lymph nodes

Mondin

Ferlito

Devaney

et al. 2010

Eur Arch Otorhinolaryngol

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In the realm of head and neck diseases, one particularly common clinical presentation is that of the patient with a cervical mass. In children, neck masses often prove to be developmental cysts; in adults, the recent onset of a neck mass can signal a metastasis from a head and neck squamous carcinoma. Less often, both adults and children may present with cervical masses caused by either non-Hodgkin's lymphoma or Hodgkin's disease. There are, of course, less frequently encountered differential diagnostic possibilities; one of the most uncommon of all is the possibility of metastasis from an intracranial tumor. Intracranial tumors rarely give rise to cervical node metastases. The present review examines the published experience with 128 tumors that gave rise to cervical node metastases in both adult and in pediatric patients. While it is presumed that the blood-brain barrier blocks the spread of most tumors beyond the intracranial locale, this is speculative. Although many of the cervical node metastases reported here arose after craniotomy (and, presumably, after breaching of the blood-brain barrier), some arose in the absence of any preceding surgical procedure. Cervical node metastases may arise from glial tumors (including glioblastoma multiforme, in both adult and pediatric patients) and non-glial tumors (such as medulloblastoma in pediatric patients). The history of a previous intracranial lesion is often the key to correct diagnosis, since, without prompting, neither the pathologist nor the radiologist is likely to think of a cervical node metastasis from a brain tumor when assessing a cervical mass of unknown etiology.

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Extra Central Nervous System Metastases from Cerebral Glioblastoma Multiforme in Elderly Patients. Clinico-Pathological Remarks on our Series of Seven Cases and Critical Review of the Literature

Cited by 82 publications

References 62 publications

Metastatic glioblastoma: case presentations and a review of the literature

Metastatic glioblastoma: case presentations and a review of the literature

Extracranial metastasis of gliobastoma: Three illustrative cases and current review of the molecular pathology and management strategies

A survey of metastatic central nervous system tumors to cervical lymph nodes

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