Multiple extracranial metastases from secondary glioblastoma: a case report and review of the literature

Abstract

Glioblastoma represents extreme anaplasia in astrocytic tumors. In spite of this aggressiveness, extracranial metastasis of glioblastoma is very rare and has been documented in only a few patients in the literature. In this article, a 30-year-old woman with secondary glioblastoma associated with extracranial distant metastasis was presented. In September 2008, an intracranial lesion in the left frontal region was diagnosed by magnetic resonance imaging (MRI) after admission to the hospital by headache and seizure and subsequently resected. The histology of the lesion revealed an anaplastic astrocytoma (grade III). Upon recurrence of the tumor 7 months later, the patient underwent a second craniotomy for recurrence tumor resection. The histological diagnosis was glioblastoma. After radiotherapy and chemotherapy, cranial computerized tomography (CT) and whole body scintigraphy revealed metastatic lesions in the right cervical lymph nodes and the left ischium. A neck dissection and parathyroidectomy on the right side was performed. The cytomorphological and histological features of the tumor supported the diagnosis of metastatic glioblastoma. KeywOrds: Glioblastoma, Extracranial metastasis, Secondary glioblastoma, Prognosis ÖZGlioblastom astrositik tümörler içerisinde en fazla anaplaziyi gösterenidir. Bu agresif davranışı yanında ekstrakraniyal metastazları oldukça nadirdir ve literatürde çok az hastada bildirilmiştir. Bu makalede, 30 yaşında sekonder glioblastoma bağlı ekstrakraniyal uzak metastazları bulunan bir bayan hasta sunulmuştur. Eylül 2008 tarihinde baş ağrısı ve nöbet şikayeti ile hastaneye başvuran hastanın çekilen kraniyal manyetik rezonans görüntülemesinde sol frontal bölgede intrakraniyal kitle saptanmıştı. Hasta opere edildi. Patoloji tanısı anaplastik astrositom (grade III)olarak raporlandı. 7 ay sonra rekürrens nedeniyle hasta tekrar opere edildi. Histolojik tanısı glioblastom olarak raporlandı. Radyoterapi ve kemoterapiden sonra çektirilen bilgisayarlı tomografi ve tüm vücut sintigrafisinde sağ servikal lenf nodları ve sol iskiumda metastatik lezyonlar saptandı. Sağ taraflı boyun diseksiyonu ve paratiroidektomi uygulandı. Sitomorfolojik ve histolojik çalışmalar metastatik glioblastomla uyumlu olarak bildirildi.

A Rare Cause of Lung Metastasis - Glioblastoma Multiforme

“…The lungs are the most common site. [3,4] Pulmonary metastasis of GBM was observed in both of the cases currently presented.…”

“…The treatment modalities for primary tumors and metastases involve surgical procedures and adjuvant chemoradiotherapy directed at the primary tissue. [4] It is thought that the use of chemotherapy after the development of metastasis is particularly helpful to improving survival. Chemotherapy was applied with RT for lung metastasis of GBM in both case 1 and case 2. posed, but the mechanism of metastasis has not yet been fully explained.…”

“…[3] Extracranial metastases are seen most frequently in the lungs, the posterior cervical soft tissue, and the lumbar intradural space. [4] Metastases are usually seen after resection of the primary tumor. [5] In the presently described cases, a mass lesion suggestive of primary pulmonary carcinoma was detected, but the pathological diagnosis was pulmonary metastasis of GBM.…”

Secondary glioblastoma with abdominal metastasis: Case report

“…performed a literature review, finding a total of 88 reported cases of GB extracranial metastases [8] . Previous studies had described an average detection time of extracranial metastasis of 8.5 months and a time to death of 1.5 months [9] . In the current case, the metastasis detection time was 1.5 months with a time to death of 1 month.…”

Extra-CNS metastasis from glioblastoma: a rare clinical entity

“…Parotid and cervical lymph nodes [50] Kim et al (2014) 1 Bone, pleural effusion [46] Hamilton et al (2014) 3 Lung, pleura, masticator muscles, parotid and vertebra [7] Takanen et al Cervical lymph nodes and ischium [52] Blume et al (2013) 1 Lung and pulmonary lymph nodes [53] Mujtaba et al (2013) 1 Cervical lymph nodes [54] Guo et al (2012) 1 Subcutaneous metastases [55] Dawar et al (2012) 1 Subcutaneous metastases, diffuse lymph node involvement, pulmonary involvement and pleural effusion [56] Ginat et al (2013) 1 Scalp metastasis [57] Seo et al (2012) 1 Left neck [58] Schonsteiner et al (2011) 1 Liver [59] Armstrong et al (2011) 1 Scalp and temporalis muscle [60] ECMGBM Review informahealthcare.com a 39-year-old male who underwent surgical resection with adjuvant radiotherapy for a high-grade pleomorphic glial neoplasm consistent with GBM. Two years after surgery, the patient developed recurrent intracranial GBM at which time a CT of the abdomen revealed a 9 Â 13 Â 10 cm mass in the false pelvis and a 5 Â 4 Â 3 cm mass within the mesentery as well as a 2 cm mass in the head of the pancreas.…”