Glioblastoma Multiforme: A Rare Case of Spinal Drop Metastasis

Sibanda, Zeluleko; Farahani, Niloufar; Ogbonnaya, Ebere Sunny; Albanese, Erminia

doi:10.1016/j.wneu.2020.08.086

Cited by 10 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One might suspect the short prognosis does not allow sufficient time for metastases to become clinically evident. In addition to the intracranial metastases of GB, intramedullary spinal metastasis, leptomeningeosis glioblastoma, and extracranial metastases are also very uncommon [ 8 , 28 , 31 , 40 – 43 ]. Several mechanisms for metastasis have been postulated, including vascular invasion, perineural spreading, and direct invasion via the lymphatics [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Abnormal Schwannoma-like Growth of multiple, multifocal BRAF V600E-positive Glioblastoma in the Interior Acoustic Canal with Leptomeningeal Infiltration: a case report

Jayarama-Naidu

Gallus

2022

J Med Case Reports

View full text Add to dashboard Cite

Background Glioblastoma belongs to the most common and most aggressive tumor entity of the central nervous system with a poor prognosis of only few months. Once manifested, it grows fast and diffusely by infiltrating the surrounding brain parenchyma. Despite its aggressive behavior, glioblastoma rarely presents with multiple lesions and metastasis to intra- and extracranial tissues. Therefore, metastasized, multiple glioblastoma is limited to case reports. Our case describes an atypical primary bilateral manifestation of BRAF V600E-positive epithelioid glioblastoma with rapid metastasis and meningeosis glioblastoma while under adjuvant chemoradiotherapy. Case presentation A 60-year-old Caucasian male patient presented with a seizure and numbness in his left arm. He was diagnosed with an abnormal primary bilateral manifestation of multiple, multifocal BRAF V600E-positive and isocitrate dehydrogenase (IDH) wild-type intracranial epithelioid glioblastoma with O6-methylguanine-DNA methyltransferase methylation (MGMT) at 12%. While being under the adjuvant chemoradiotherapy with temozolomide, the patient developed left-sided facial nerve weakness and hearing loss, dysarthria, and severe gait instability. Cranial magnetic resonance imaging showed that glioblastoma lesions advanced rapidly with a schwannoma-like growth pattern by invading the left internal acoustic meatus, adjacent cranial nerves, and leptomeninges. A lumbar puncture confirmed meningeosis glioblastoma. Four months after the initial diagnosis of glioblastoma, the patient died from the complications of the fast and diffuse metastasis. Conclusions Glioblastoma rarely presents with metastases despite its aggressive and rapidly growing nature. Our case should increase awareness of symptom tracking in patients with glioblastoma to intervene early and efficiently. Moreover, refractory therapies for glioblastoma should underline the importance of personalized medicine.

show abstract

Section: Discussionmentioning

confidence: 99%

Abnormal Schwannoma-like Growth of multiple, multifocal BRAF V600E-positive Glioblastoma in the Interior Acoustic Canal with Leptomeningeal Infiltration: a case report

Jayarama-Naidu

Gallus

2022

J Med Case Reports

View full text Add to dashboard Cite

show abstract

“…Notably, the incidence is higher in cerebellar GBM [8]. The majority of spinal dissemination of GBM occurs through leptomeningeal spread; this accounts for a majority of extracranial metastasis of GBM [9,10].…”

Section: Discussionmentioning

confidence: 99%

Leptomeningeal disease in glioblastoma: endgame or opportunity?

et al. 2021

View full text Add to dashboard Cite

Introduction: Glioblastoma is an aggressive cancer with a notoriously poor prognosis. Recent advances in treatment have increased overall survival, though this may be accompanied by an increased incidence of leptomeningeal disease (LMD). LMD carries a particularly severe prognosis and remains a late stage manifestation of glioblastoma without satisfactory treatment. The objective of this review is to survey the literature on treatment of LMD in glioblastoma and to more fully characterize the current therapeutic strategies.Methods: The authors performed a systematic review following PRISMA criteria on PubMed. Articles that included adult patients with LMD from glioblastoma multiforme were retrieved and reviewed.Results: LMD in glioblastoma patients is increasing in incidence, with reports of up to 21%. The overall survival without treatment is alarmingly brief, with patients surviving between 1.6-3.8 months. All studies showed that treatment does improve overall survival signi cantly, increasing to 11.7 months in one study. However, no one adjuvant or surgical therapy has been shown to improve survival in LMD signi cantly over another. Direct treatment methods include chemotherapy (standard, anti-angiogenic, intrathecal, immunotherapy), and radiation. Hydrocephalus is a complication in LMD that can be treated with ventriculoperitoneal shunt placement, however treating hydrocephalus and delivering intrathecal chemotherapy is a challenge. Conclusion: Though evidence remains lacking and there is no consensus, treatments show a trend towards improving survival and should be considered on a case-by-case basis. Further studies are necessary in the pursuit of a standard of care.

show abstract

“…Spinal dissemination of intracranial glioblastoma is shown several times in literature. 4,5 On the other hand, intracranial invasion of primary spinal glioblastoma are reported less frequently. 6,7 Glioblastoma is shown to metastasize in subarachnoid space and infiltrate myelin cells.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Dissemination of Primary Spinal Glioblastoma

Sirinoglu

Sarigul

Başkurt

et al. 2021

Indian Journal of Neurosurgery

View full text Add to dashboard Cite

Background Primary spinal glioblastoma is a rare lesion which constitutes only 1.5% of all spinal tumors. Diagnosis is challenging due to absence of any radiological hallmark of the disease. Even though surgery combined with chemoradiotherapy is the optimal management for these tumors, prognosis is still poor. Dissemination of glioblastoma is reported several times in the literature, which is correlated with worse prognosis and outcome. This case report that we are presenting is the first case where dissemination of primary spinal glioblastoma dissemination is limited only to spinal cord, without intracranial invasion, and regression was achieved with chemoradiotherapy. Case Report In this article, a patient with primary spinal glioblastoma who presented with paraparesia is presented. Patient underwent surgery for resection of the tumor and received adjuvant radiotherapy. However, 9 months postoperatively, dissemination was detected in epidural and subdural spaces of spinal canal, with concomitant compression of spinal cord. There was no radiographically detected lesion in cranial MRI. He underwent second session of radiotherapy, combined with chemotherapy and steroid. Five months later, regression of metastatic disseminated lesions was observed. Conclusion Primary spinal glioblastoma is a rare pathology and known to have a poor prognosis, notably with dissemination of the disease. Even though further biomolecular studies are necessary to explain the pathophysiology better, chemotherapy and radiotherapy may be effective in regression of disseminated lesions.

show abstract

Glioblastoma Multiforme: A Rare Case of Spinal Drop Metastasis

Cited by 10 publications

References 16 publications

Abnormal Schwannoma-like Growth of multiple, multifocal BRAF V600E-positive Glioblastoma in the Interior Acoustic Canal with Leptomeningeal Infiltration: a case report

Abnormal Schwannoma-like Growth of multiple, multifocal BRAF V600E-positive Glioblastoma in the Interior Acoustic Canal with Leptomeningeal Infiltration: a case report

Leptomeningeal disease in glioblastoma: endgame or opportunity?

A Rare Case of Dissemination of Primary Spinal Glioblastoma

Contact Info

Product

Resources

About