A case of spinal cord glioblastoma multiforme with intracranial dissemination is reported. A 23-year -old female was admitted to a local hospital complaining of lumbago. Myelography revealed an in tramedullary thoracic tumor. The tumor was partially removed through a laminectomy at Th 11-L1. The histological diagnosis was glioblastoma multiforme, and focal irradiation (total 50 Gy) was given. Eight months after the operation, symptoms of increased intracranial pressure appeared. Computed tomographic (CT) scans showed marked hydrocephalus, and multiple tumors at anterior horns of bilateral lateral ventricles. A ventriculoperitoneal shunt and an Ommaya reservoir into the left lateral ventricle were emplaced. Three months later, she was transferred to our hospital. CT scans showed enhanced lesions in the fourth ventricle, anterior horn of the left lateral ventricle, sep tum pellucidum, and pituitary gland. Suboccipital craniectomy was performed, and the mass around the fourth ventricle was partially removed. Histological examination of the tumor specimens showed glioblastoma multiforme. Postoperatively, she received whole brain irradiation (total 50 Gy), and intrathecal injection of β-interferon via the Ommaya reservoir. However, she died of respira tory insufficiency. It is considered that the spinal cord glioblastoma multiforme disseminated into the intracranial space.

No abstract

We evaluated retrospectively the pharmacokinetics and boron uptake of BSH (mercaptoundecahydrododecarborate) for Boron Neutron Capture Therapy (BNCT) in 123 patients undergoing craniotomy for intracranial tumors. The pharmacokinetics revealed that BSH could move easily from blood to the peripheral organs; it was retained there and elimination was very slow. BSH after intra-arterial infusion (i.a.) was found to move into the peripheral organs more easily than after intra-venous (i.v.) infusion. In patients with malignant glioma, the average values of boron concentration in tumor and the tumor to blood ratio (T/B ratio) after i.a. infusion were 26.8 +/- 19.5 micrograms/g (range, 6.1-104.7 micrograms/g) and 1.77 +/- 1.30 (range, 0.47-6.65) respectively. On the other hand, after i.v. infusion the values were 20.9 +/- 12.2 micrograms/g (range, 7.0-39.7 micrograms/g) and 1.30 +/- 0.65 (range, 0.61-2.94) respectively. The differences are not statistically significant. Boron uptake in malignant glioma was about three times higher than low grade glioma. We found a good correlation between boron uptake and time interval from BSH infusion, and 15-20 hours after BSH infusion the boron concentration in tumor was above 20 micrograms/g 10B in 69% of the malignant glioma patients; T/B ratio was above one in 75%, and above two in 44% of them. We recommend intra-venous infusion of BSH clinically since it is safer, and results in sufficient boron concentration in tumor, and the planned irradiation might be optimal around 15-20 hours after the BSH infusion for treating malignant glioma.

No abstract