Document Type: Case Reports

Authors

1 Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Pathology, Sina hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Tehran University of Medical Sciences

Abstract

Glioblastoma (WHO grade IV) is the most common malignant tumor of neural tissues in adults as a primary tumor. Because of blood brain barrier and short median survival of patients with glioblastoma, metastasis of this tumor is very rare. A 46-year-old man was admitted to Sina hospital with chief complaint of headache and visual impairment. After neuro-radiologic evaluation the patient underwent surgery. Pathologic examination of the tumor confirmed the diagnosis of glioblastoma multiforme. Cytogenetic study of the tumor cells confirmed GBM IDH1 wild type with TERT mutation and EGFR amplification. Two months after surgical resection, the tumor recurred with involvement of the dura matter. After the second operation, metastasis to the pelvic cavity and cervical lymph node was found. Almost all cases of glioblastoma metastasis had undergone surgery or any manipulation; this fact suggests that iatrogenic intra-vascular seeding of tumor cells at the time of resection and disruption of blood brain barrier could cause extra-neural metastasis.

Keywords

Main Subjects

  1. Cunha M, Maldaun M. Metastasis from glioblastoma multiforme: a meta-analysis. Rev Assoc Med Bras (1992). 2019 Mar;65(3):424-433. [DOI:10.1590/1806-9282.65.3.424] [PMID]
  2. Wu W, Zhong D, Zhao Z, Wang W, Li J, Zhang W. Postoperative extracranial metastasis from glioblastoma: a case report and review of the literature. World J Surg Oncol. 2017; 15: 231 [DOI:10.1186/s12957-017-1300-7] [PMID] [PMCID]
  3. Schou Nørøxe D, Regner Michaelsen S, Broholm H, Møller S, Skovgaard Poulsen H, Lassen U. Extracranial metastases in Glioblastoma-Two case stories. Clin Case Rep. 2019 Feb; 7(2): 289-294. [DOI:10.1002/ccr3.1980] [PMID] [PMCID]
  4. Hoffman H, Li C, Everson R, Strunck J, Yong W, Lu D. Primary lung metastasis of glioblastoma multiforme with epidural spinal metastasis: Case report. J Clin Neurosci. 2017 Jul; 41:97-99. [DOI:10.1016/j.jocn.2017.03.033] [PMID]
  5. Liu J, Shen L,Tang G, Tang S, Kuang W, Li H, Tian Y, Zhou Q. Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review. J Int Med Res. 2020 Jun; 48(6): 0300060520930459. [DOI:10.1177/0300060520930459] [PMID] [PMCID]
  6. Rosen J, Blau T, Grau S, Barbe M, Fink G, Galldiks N. Extracranial Metastases of a Cerebral Glioblastoma: A Case Report and Review of the Literature. Case Rep Oncol. 2018 May-Aug; 11(2): 591-600. [DOI:10.1159/000492111] [PMID] [PMCID]
  7. Xiao H, Bai J, Yan M, Ji K, Tian W, Liu D Et al. Metastatic glioblastoma multiforme: A rare case of long-term survival. Biomedical Research. 2018;29(6). [DOI:10.4066/biomedicalresearch.29-17-772]
  8. Granados A, Zuñiga N, Ospina C, Merchancano L. Secondary glioblastoma with abdominal metastasis: Case report. Radiol Case Rep. 2018 Feb 3;13(2):347-351. [DOI:10.1016/j.radcr.2018.01.004] [PMID] [PMCID]
  9. Vuignier S, Tokairin K, Aoyama T, et al. Vertebral Metastasis of A Cerebellar Glioblastoma Multifome - A Case Report -. iMedPub. 2014;5(2.2).
  10. Minniti G, Lombardi G, Paolini S. Glioblastoma in Elderly Patients: Current Management and Future Perspectives. Cancers (Basel). 2019 Mar; 11(3): 336. [DOI:10.3390/cancers11030336] [PMID] [PMCID]
  11. Sun Q, Xu R, Xu H, Wang G, Shen X, Jiang H. Extracranial metastases of high-grade glioma: the clinical characteristics and mechanism. World J Surg Oncol. 2017; 15: 181. [DOI:10.1186/s12957-017-1249-6] [PMID] [PMCID]
  12. Costa R, Costa R, Kaplan J, Cruz M, Shah H, Matsangou M et al. A Rare Case of Glioblastoma Multiforme with Osseous Metastases. Case Rep Oncol Med. 2017; 2017: 2938319. [DOI:10.1155/2017/2938319] [PMID] [PMCID]
  13. Cunha M, Maldaun, M. Metastasis from glioblastoma multiforme: a meta-analysis. Revista da Associação Médica Brasileira. 2019; 65(3), pp.424-433. [DOI:10.1590/1806-9282.65.3.424] [PMID]
  14. RAY A, MANJILA S, HDEIB A, RADHAKRISHNAN A, NOCK C, COHEN M et al. Extracranial metastasis of glioblastoma. Three illustrative cases and current review of the molecular pathology and management strategies. Mol Clin Oncol. 2015 May; 3(3): 479-486. [DOI:10.3892/mco.2015.494] [PMID] [PMCID]
  15. Lewis G, Rivera A, Tremont-Lukats I, Ballester-Fuentes L, Zhang Y, Teh B. GBM skin metastasis: a case report and review of the literature. CNS Oncol. 2017 Jul; 6(3): 203-209. [DOI:10.2217/cns-2016-0042] [PMID] [PMCID]