Glioblastoma multiforme with extracranial metastases in the absence of previous craniotomy

Anzil, A. P.

doi:10.3171/jns.1970.33.1.0088

Cited by 105 publications

(62 citation statements)

References 26 publications

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“…7 Metastases from GM may follow cerebrospinal fluid (CSF) diversion, 2,9 or vascular tumor invasion within the CNS. 10 In addition, the malignant cells may gain access to the extrameningeal tissue as a result of spontaneous perforation of the dura 11,12 or dura and bone, 13 but most frequently, as in our case, it follows a craniotomy. 3 The mechanism by which surgery predisposes to metastasis from GM is not fully determined.…”

Section: Discussionmentioning

confidence: 99%

“…The most plausible explanation is that during the surgical procedure the extrameningeal tissues are exposed to dislodged neoplastic cells which are capable of invading the lymphatics and extradural vasculture. 5,11 This process may continue in the postoperative period if the dura is left open. 3 In addition, it has been suggested that the postoperative reparative processes may generate new capillaries with fragile walls that are susceptible to invasion.…”

Section: Discussionmentioning

confidence: 99%

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Cervical Lymph Node Metastasis from A Glioblastoma Multiforme in A Child: Report of A Case and A Review of The Literature

Ur-Rahman

et al. 1997

Ann Saudi Med

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AB Jamjoom, ZAB Jamjoom, N-U-Rahman, AC Al-Rikabi, Cervical Lymph Node Metastasis from a Glioblastoma Multiforme in a Child: Report of a Case and a Review of the Literature. 1997; 17(3): 340-343 Glioblastoma multiforme (GM) does not usually metastasize outside the central nervous system (CNS), and is rarer in children than in adults.1 To our knowledge, only 11 cases of childhood GM with extraneural metastasis (ENM) have thus far been reported in the literature. [1][2][3][4] The authors report a case of a four-yearrold male patient with a GM who developed cervical lymph node metastasis seven months after the original presentation. This case and the 11 previously reported pediatric cases were grouped together and their clinical characteristics were compared with the clinical features of the 68 adult cases that have been reported in the literature up to 1995. [4][5][6][7][8] The study is an attempt to identify some of the features of ENM from GM which are unique to children. Case HistoryA four-year-old male Indian patient was admitted to the Neurosurgical Division at King Khalid University Hospital (KKUH) in April 1995 with a one-month history of headache, associated with anorexia and vomiting. On examination, the patient was inactive. He had papilledema and a left homonomous hemianopia but otherwise no neurological deficits. CT scan (Figure 1) showed a large right occipital lesion with irregular contrast enhancement, surrounding edema and mass effect. The patient underwent a craniotomy and total macroscopic excision of a vascular necrotic tumor. Histology (Figure 2) confirmed the tumor to be a glioblastoma multiforme which was focally positive to glial fibrillary acidic protein (GFAP). The postoperative recovery was uneventful and the followup CT scan showed no evidence of any residual tumor.Referral for radiotherapy treatment was made but the child's parents declined the treatment. A month later, the patient was readmitted because of bulging of the bone flap at the site of the craniotomy, which was associated with vomiting. He remained conscious and apart from a left homonomous hemianopia he had no neurological deficits. CT scan showed a large recurrence of the tumor at the same location. The craniotomy was reopened and a total macroscopic excision of the recurrence was performed. There was no evidence of tumor invasion of the dura or the bone flap. The dura was closed and the bone flap was replaced. The postoperative recovery was uneventful and the follow-up CT scan showed no evidence of residual tumor. Histology confirmed the diagnosis of a recurrent glioblastoma multiforme. On this occasion the patient received radiotherapy treatment to the whole cranium (4000 cGy over four weeks, with a daily dose of 200 cGy), and tolerated it well.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cervical Lymph Node Metastasis from A Glioblastoma Multiforme in A Child: Report of A Case and A Review of The Literature

Ur-Rahman

et al. 1997

Ann Saudi Med

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“…A 1970 review by Anzil showed that there was no documented surgical intervention in more than 10% of patients with metastatic glioblastoma [12]. In these cases, the mechanism of extra-cranial spread is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Glioblastoma: A Case Report and Review of the Literature

Harrison¹,

Hulette²,

Guy³

et al. 2016

J Med Surg Pathol

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Glioblastoma, the most common and aggressive primary glial tumor, has a median survival time of approximately 3 months without medical treatment. Surgical resection, radiotherapy, and chemotherapy are the main methods of treatment and have been shown to increase life expectancy 1 to 2 years. The tumor has an infiltrative growth pattern that distorts the normal anatomy and can extend to distant parts of the brain along white matter tracts. While glioblastoma commonly infiltrates surrounding brain tissue and intracranial metastases to the meninges and spinal cord are frequently reported, extra-cranial metastases are extremely rare. This is most probably due to the lack of lymphatic vessels in the brain and inability of the malignant cells to invade blood vessels. We present a case of a 56-year-old female with a history of right temporal glioblastoma, who was found to have biopsy proven metastases to the lung. The patient presented for a chest x-ray, as part of a requirement for a clinical trial, and was found to have bilateral lung nodules; a subsequent chest computed tomography (CT) scan showed numerous pulmonary nodules and low density lesions in the liver. The patient underwent right thoracoscopic wedge resection. Frozen section and permanent sections were diagnostic of metastatic glioblastoma.

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“…Invasion of the dural veins is seen in most cases of extracranial metastases from glioblastoma in patients who did not undergo craniotomy. 1,12,17) Spontaneous extracranial metastases might be expected in patients with tumors attached to and invading the dura, 4) such as two cases of the transdural extension of gliomas. 11) Direct contact between the tumor and the basal dura, intracranial hypertension, structural weakness, and surgery can allow tumor cells to migrate through the dura.…”

Section: Discussionmentioning

confidence: 99%

“…Metastases from glioblastoma occur in the lung, lymph nodes, 9,14) bone, 1,2,5) bone marrow, 6) and liver. Metastasis to the spleen is extremely rare, with only three cases reported.…”

Section: Introductionmentioning

confidence: 99%

Glioblastoma With Metastasis to the Spleen -Case Report-

Yasuhara

Tamiya

Meguro

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 47-year-old woman presented with headache and left homonymous hemianopsia. T 1 -weighted magnetic resonance (MR) imaging with contrast medium showed a mass lesion with ring-like enhancement in the right temporo-occipital lobe. The patient underwent surgery, focal irradiation, and chemotherapy. The histological diagnosis was glioblastoma. Four months after the operation, the patient again developed headache and left homonymous hemianopsia in addition to vomiting and mild left hemiparesis. MR imaging showed recurrence of the tumor and hydrocephalus. The patient underwent a second craniotomy and placement of a ventriculoperitoneal shunt. Intraoperative findings revealed that the transverse-sigmoid sinus was occluded by tumor invasion. The patient died of intraventricular dissemination 2 months after the second operation. Autopsy revealed metastases in the spleen and lungs. Glioblastoma with metastases to the spleen is very rare. The prognosis for patients is poor. Excessive therapy should not be used for patients with extracranial metastases from glioblastoma.

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Glioblastoma multiforme with extracranial metastases in the absence of previous craniotomy

Cited by 105 publications

References 26 publications

Cervical Lymph Node Metastasis from A Glioblastoma Multiforme in A Child: Report of A Case and A Review of The Literature

Cervical Lymph Node Metastasis from A Glioblastoma Multiforme in A Child: Report of A Case and A Review of The Literature

Metastatic Glioblastoma: A Case Report and Review of the Literature

Glioblastoma With Metastasis to the Spleen -Case Report-

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