Bone Metastases of Glioblastoma: A Case Report and Review of the Literature

Abstract

BackgroundGlioblastoma (GBM) is the most common primary intracranial tumor and originates from the small pool of adult neural stem and progenitor cells (NSPCs). According to the World Health Organization (WHO) classification of brain tumors, gliomas are classified into grades I–IV, and GBM is defined as the highest grade (IV). GBM can be disseminated by cerebrospinal fluid (CSF), but extracranial metastasis is rare. Additionally, the pathway and mechanism involved remain unclear.Case PresentationWe report a rare case of left temporal lobe GBM with multiple bone metastases and soft tissue metastasis. This 49-year-old right-handed man who was diagnosed with GBM underwent surgery on May 9, 2017, followed by radiochemotherapy in June 2017. On August 13, 2019, local relapse was found. Then, the patient received a second surgery but not radiochemotherapy. In November 2019, the patient was reported to be suffering from low back pain for nearly 1 month. On December 6, 2019, magnetic resonance imaging (MRI) of the thoracolumbar vertebrae and abdominal computed tomography (CT) confirmed metastases on the ninth posterior rib on the right, the third anterior rib on the left, and the T7 and T10 vertebrae and their appendages. CT-guided rib space-occupying puncture biopsy was performed, and GBM was identified by pathology.ConclusionWe should pay attention to extracranial metastasis of GBM. Timely detection and early treatment improve overall quality of patients’ life. The extracranial metastasis in this patient may have occurred through the spinal nerve root or intercostal nerve. Further clinical observations are required to clarify the pathway and mechanism involved.

Pediatric H3K27M‑mutant diffuse midline glioma with vertebral metastasis: A case report and literature review

“…The most common cause of bone metastasis may be venous invasion to the Batson plexus of the spine ( 28 ). Recent study have reported that malignant tumor cells may migrate through nerve roots ( 29 ). All the aforementioned cases reported multiple vertebral metastases with extensive craniospinal pial seeding.…”

Glioblastoma multiforme with vertebral metastases: A case report

“… 5 , 6 , 7 However, the highly invasive growth and poor prognosis lead to too short overall survival time to form metastases. 8 Furthermore, craniotomy and other invasive procedures, such as biopsy, could break the blood‐brain barrier, creating conditions for glioma cells to migrating into the systemic circulation. 9 Most metastases cases reported in previous studies involved primary tumor resection before the formation of extracranial metastases.…”

“… 9 Most metastases cases reported in previous studies involved primary tumor resection before the formation of extracranial metastases. 8 , 9 …”

“…9 Most metastases cases reported in previous studies involved primary tumor resection before the formation of extracranial metastases. 8,9 Recent studies have demonstrated that genetic alterations are related to GBM-derived bone metastases, such as mutation of in BRCA1, ARID1A, and C8A-R30W, or overexpression of IGFBP2. [10][11][12] We identified several GBM metastasis-related genes described in previous studies.…”

Bone Metastasis From Glioblastoma Multiforme: A Case Report

“…Only 200 cases have been reported in worldwide literature. The osseous tissue continues to be an exceptional place to present metastases [ 3 ]. It belongs to the grade IV of the world health organization (WHO) classification and represents nearly 60% of brain malignant tumors in adults [ 4 , 5 ].…”