Extracranial metastases in glioblastoma—Two case stories

Nørøxe, Dorte Schou; Michaelsen, Signe Regner; Broholm, Helle; Möller, Sören; Poulsen, Hans Skovgaard; Lassen, Ulrik

doi:10.1002/ccr3.1980

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Historically, one of the major concern of shunt implantation in glioblastoma patients is the risk of peritoneal metastasis (32,(38)(39)(40)(41). However, it is now well established that spread by shunts is a rare albeit potential serious complication in highgrade gliomas.…”

Section: Discussionmentioning

confidence: 99%

Hydrocephalus Shunting in Supratentorial Glioblastoma: Functional Outcomes and Management

et al. 2022

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BackgroundGlioblastoma is the most common and the most challenging to treat adult primary central nervous system tumor. Although modern management strategies modestly improved the overall survival, the prognosis remains dismal associated with poor life quality and the clinical course often dotted by treatment side effects and cognitive decline. Functional deterioration might be caused by obstructive or communicating hydrocephalus but due to poor overall prognosis surgical treatment options are often limited and its optimal management strategies remain elusive. We aimed to investigate risk factors, treatment options and outcomes for tumor-associated hydrocephalus in a contemporary 10 years cohort of glioblastoma patients.MethodsWe reviewed electronic health records of 1800 glioblastoma patients operated at the Department of Neurosurgery, Medical Center – University of Freiburg from 2009 to 2019. Demographics, clinical characteristics and radiological features were analyzed. Univariate analysis for nominal variables was performed either by Fisher’s exact test or Chi-square test, as appropriate.ResultsWe identified 39 glioblastoma patients with symptomatic communicating hydrocephalus treated by ventricular shunting (incidence 2.1%). Opening of the ventricular system during a previous tumor resection was associated with symptomatic hydrocephalus (p<0.05). There was also a trend toward location (frontal and temporal) and larger tumor volume. Number of craniotomies before shunting was not considered as a risk factor. Shunting improved hydrocephalus symptoms in 95% of the patients and Karnofsky Performance Score (KPS) could be restored after shunting. Of note, 75% of the patients had a post-shunting oncological treatment such as radiotherapy or chemotherapy, most prevalently chemotherapy. Infection (7.7%) and over- or under drainage (17.9%) were the most common complications requiring shunt revision in ten patients (25.6%), No peritoneal metastasis was found. The median overall survival (OS) was 385 days and the median post shunting survival was 135 days.ConclusionVentricular system opening was identified as a risk factor for communicating hydrocephalus in glioblastoma patients. Although glioblastoma treatment remains challenging, shunting improved hydrocephalus-related functional status and may be considered even in a palliative setting for symptom relief.

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Section: Discussionmentioning

confidence: 99%

Hydrocephalus Shunting in Supratentorial Glioblastoma: Functional Outcomes and Management

et al. 2022

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“…As such, scalp metastasis is usually located close to the surgical incision site, and this suggested that direct tumor seeding is a possible mechanism (12). To our knowledge, less than 20 cases of scalp metastases from GBM cells seeding were described (3,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). We summarize GBM patients with scalp involvement to further explore the characteristics of scalp metastasis (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Rapid progression of subcutaneous glioblastoma: A case report and literature review

et al. 2023

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Extra-neural spread of glioblastoma (GBM) is extremely rare. We report a case of postoperative intracranial GBM spreading to the subcutaneous tissue via the channel of craniotomy defect in a 73-year-old woman. Radiological images and histopathology indicate that the tumor microenvironment of the subcutaneous tumor is clearly different from the intracranial tumor. We also model the invasion of GBM cells through the dura-skull defect in mouse. The retrospective analysis of GBM with scalp metastases suggests that craniectomy is a direct cause of subcutaneous metastasis in patients with GBM. Imaging examinations of other sites for systemic screening is also recommended to look for metastases outside the brain when GBM invades the scalp or metastasizes to it.

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“…Likewise, leptomeningeal spread is rare, occurring in 2-4% of GBM patients. Most patients are young and male and have undergone prior surgery, which is believed to allow cancer cells to access the extracerebral blood and lymphatic vessels [4]. Few case reports have been previously reported in which a single tissue or organ metastasis was present.…”

Section: Introductionmentioning

confidence: 99%

Glioblastoma Multiforme With CDKN2A, Loss of PTEN and EGFR Amplification, and Diffuse Distant Organ Metastasis Treated With Six Lines of Therapy: A Case Report and Literature Review

Aslan¹,

Günaydin²,

Yukruk³

et al. 2022

Cureus

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In glioblastoma multiforme (GBM) cases, the tumor usually remains limited to the central nervous system in the expected disease course. Here, we discuss the case of a 41-year-old male patient who presented with extracranial spread, which has been reported in a limited number of cases in the literature. The patient received six lines of treatment including radiotherapy with temozolomide, irinotecan-bevacizumab combination, lomustine, erlotinib, everolimus, and weekly carboplatin-paclitaxel. In addition to systemic treatment, the patient underwent radiotherapy and surgery twice. Despite presenting with features consistent with a poor prognosis and extensive multi-organ metastasis, the patient achieved an overall survival of 25 months. In our view, the clinical course of our case, the follow-up, and the treatment process will add to the literature.

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Extracranial metastases in glioblastoma—Two case stories

Cited by 9 publications

References 16 publications

Hydrocephalus Shunting in Supratentorial Glioblastoma: Functional Outcomes and Management

Hydrocephalus Shunting in Supratentorial Glioblastoma: Functional Outcomes and Management

Rapid progression of subcutaneous glioblastoma: A case report and literature review

Glioblastoma Multiforme With CDKN2A, Loss of PTEN and EGFR Amplification, and Diffuse Distant Organ Metastasis Treated With Six Lines of Therapy: A Case Report and Literature Review

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