Extracranial growth of glioblastoma multiforme

Forsyth, Tiara M.; Bi, Wenya Linda; Abedalthagafi, Malak; Dunn, Ian F.; Chiocca, E. Antonio

doi:10.1016/j.jocn.2015.03.018

Cited by 29 publications

(26 citation statements)

References 13 publications

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“…3 Metastatic GBM may thus occur by migration of GBM cells in the CSF through shunts to the peritoneum or peritoneal cavity, 15 or direct seeding to soft tissues through craniotomy defects. 16 However, surgery is not a prerequisite for extracranial metastasis of GBM, and extra-CNS metastases have been reported in both adults and children without craniotomy. [17][18][19][20] Endogenous factors may also result in the extracranial spread of GBM.…”

Section: Discussionmentioning

confidence: 99%

“…2 Prophylactic craniospinal irradiation may be considered in patients at high risk of CSF seeding, if the ventricles were opened during surgery or if the tumor was in close contact with the CSF. 16,25 Previous studies have also suggested that local chemotherapy combined with anti-programmed cell death protein 1 agents can facilitate an antitumor immune response and improve survival in GBM patients. 26 Moreover, tumor-treating fields (TTFields) was confirmed to improve OS and PFS in the phase 3 EF-14 trial in patients with GBM.…”

Section: Discussionmentioning

confidence: 99%

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Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review

et al. 2020

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Extracranial metastasis from glioblastoma multiforme (GBM) is rare, especially multi-site metastases without intracranial recurrence. However, the metastatic mechanism of GBM remains unknown and there is currently no consensus regarding the best therapeutic regimen. We report the case of a 46-year-old man with primary GBM who developed scalp metastases and subsequent multiple pulmonary metastases. He was treated with the Stupp regimen after surgery for the intracranial tumor. However, a series of soft masses in the scalp were subsequently identified, and new nodules were found in his left eyebrow arch during chemoradiotherapy. Despite salvage chemotherapy and targeted therapy, the patient eventually died of respiratory failure with multiple pulmonary metastases. This case highlights the need for rigorous follow-up, including brain magnetic resonance imaging, in patients with GBM. The occurrence of extra-central nervous system symptoms indicates the possibility of metastasis, and the relevant examinations should be conducted promptly. Positive therapies may help to relieve symptoms and prolong survival in patients with metastatic GBM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review

et al. 2020

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“…To the best of our knowledge, $ 21 cases have been reported in the literature so far (►Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22] In our case, the review of the radiological and intraoperative findings points to the hypothesis of soft tissue tumor dissemination through the surgical wound site.…”

Section: Introductionmentioning

confidence: 90%

Subcutaneous Dissemination in Highly Aggressive Intracranial Glioblastoma: Case Report and Literature Review

2016

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Glioblastoma (GBM) is a highly invasive and incurable primary central nervous system (CNS) tumor. Despite its aggressive behavior, extracranial metastases are rare, with an estimated incidence of less than 2%. In our literature review, we found only 21 reported cases of skin and soft tissue dissemination. We report a case of an early (two and a half months) postoperative skin and muscle flap-associated dissemination of a temporal glioblastoma. The particular aspect of this case, besides its rarity, is that the clinical presentation, the image reports and even the surgical findings were always in favor of a postoperative subdural empyema and epicranial abscesses. The diagnosis of soft tissue dissemination was only possible after negative microbiological cultures and histopathological confirmation of muscle and skin invasion by the tumor. This case illustrates the rare but potential risk of myocutaneous flap tumor dissemination through the durotomy/craniotomy site that can mimic a much more common, post-surgical infection. Palavras-chave► disseminação nos tecidos moles ► glioblastoma ► empiema subdural ► abcesso cerebral ResumoO glioblastoma é um tumor do sistema nervoso central extremamente invasivo e incurável. Apesar do comportamento agressivo desses tumores, a metastização extracraniana é rara, apresentando uma incidência inferior a 2%. A nossa revisão da literatura revelou apenas 21 casos descritos de disseminação de glioblastoma para a pele e tecidos moles. Nós descrevemos um caso de disseminação precoce de um glioblastoma temporal para o retalho miocutâneo associado à cirurgia, cerca de 2 meses e meio após a intervenção. Além da raridade, este caso é peculiar, uma vez que tanto a forma de apresentação clínica quanto a descrição imagiológica e os achados intraoperatórios foram sempre muito sugestivos de um empiema subdural e de abcessos epicranianos. O diagnóstico definitivo de disseminação tumoral para os tecidos moles apenas foi possível após o resultado negativo das culturas microbioló-gicas e a confirmação histológica de invasão do músculo e da pele pelo tumor. Este caso ilustra o raro, mas potencial risco de disseminação tumoral de um glioblastoma através do retalho miocutâneo de acesso cirúrgico e do local de craniotomia/durotomia, que se pode facilmente confundir com uma situação mais frequente de infecção após cirurgia.

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“…Pietschmann et al, in their systematic review, assessed articles published from 1928 to 2013 and found 109 eligible studies, with a total of 150 patients diagnosed with GBM systemic metastasis 12 . From the data of the survey carried out for this study, other 14 cases reports were found from 2014 to 2017, totaling 17 patients 8, [13][14][15][16][17][18][19][20][21][22][23][24] . The authors demonstrated that the average time from the initial diagnosis to the metastasis was nine months; the average survival after the metastasis was six months 12 .…”

Section: Introductionmentioning

confidence: 99%

Systemic dissemination of glioblastoma: literature review

Carvalho¹,

Barbosa

Feher

et al. 2019

Rev. Assoc. Med. Bras.

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SUMMARY INTRODUCTION: Glioblastoma (GBM) is the most frequent primary malignant tumor from the central nervous system in adults. However, the presence of systemic metastasis is an extremely rare event. The objective of this study was to review the literature, evaluating the possible biological mechanisms related to the occurrence of systemic metastasis in patients diagnosed with GBM. RESULTS: The mechanisms that may be related to GBM systemic dissemination are the blood-brain barrier breach, often seen in GBM cases, by the tumor itself or by surgical procedures, gaining access to blood and lymphatic vessels, associated with the acquisition of mesenchymal features of invasiveness, resistance to the immune mechanisms of defense and hostile environment through quiescence. CONCLUSIONS: Tumor cells must overcome many obstacles until the development of systemic metastasis. The physiologic mechanisms are not completely clear. Although not fully understood, the pathophysiological understanding of the mechanisms that may be associated with the systemic spread is salutary for a global understanding of the disease. In addition, this knowledge may be used as a basis for a therapy to be performed in patients diagnosed with GBM distant metastasis.

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Extracranial growth of glioblastoma multiforme

Cited by 29 publications

References 13 publications

Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review

Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review

Subcutaneous Dissemination in Highly Aggressive Intracranial Glioblastoma: Case Report and Literature Review

Systemic dissemination of glioblastoma: literature review

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