Multifocal Glioblastoma with Remote Cutaneous Metastasis: A Case Report and Review of the Literature

Miliaras, George; Tsitsopoulos, Parmenion P.; Markoula, Sofia; Kyritsis, Athanassios P.; Polyzoidis, Konstantinos S.; Malamou-Mitsi, Vasiliki

doi:10.1055/s-2008-1080941

Cited by 27 publications

(12 citation statements)

References 24 publications

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“…Age is a wellknown prognostic factor, with decreased survival based on age, so increased survival may place some patients at higher risk. Other relevant factors are primary tumor proximity to the ventricular system, whether or not the tumor is multifocal [47], and the functional status of patients at the time of GBM diagnosis. We considered these factors but available data was insufficient for analysis.…”

Section: Discussionmentioning

confidence: 99%

Metastatic glioblastoma: case presentations and a review of the literature

et al. 2011

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Extracranial metastases from glioblastoma (GBM) are uncommon with an estimated incidence of less than 2%. We report two cases of metastatic GBM seen within an 8-week period followed by a literature review. We attempted to identify common factors or a causative mechanism. Factors that predominated among the reviewed cases included male gender, tumor location, and younger age. Causative mechanisms were not apparent. While metastatic disease remains rare, it might be occurring with increasing frequency. This trend might be due to increased diagnosis, better imaging, a more extensive physician workup, or an increase in survival. Metastatic GBM can present and progress quite rapidly, and repeat evaluations of persistent or worsening complaints among GBM patients are warranted. Early diagnosis of metastatic disease spread can help to expedite alleviation of patients' discomfort, in an already aggressive disease process.

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Section: Discussionmentioning

confidence: 99%

Metastatic glioblastoma: case presentations and a review of the literature

et al. 2011

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“…Sometimes additional foci of multicentric glioblastomas can be identified using positron emission tomography [38], which may also be effective in delineating the proliferative potential of glioma cells [39,40]. Rarely, multifocal gliomas can metastasize outside the CNS [41,42]. …”

Section: Imagingmentioning

confidence: 99%

Diagnosis and Management of Multifocal Gliomas

Giannopoulos¹,

Kyritsis²

2010

Oncology

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Patients who present with multiple cerebral tumors are usually considered as having metastatic disease. If they have a history of a primary cancer in another site, the brain tumors are considered metastases and are usually managed with standard whole-brain radiotherapy. If no primary cancer site is known, a diagnostic work-up is performed, but if no primary site is found, they are still considered as brain metastases from an unknown primary site. Thus, such patients can either have brain biopsy (recommended) for further diagnostic consideration or, occasionally, they can be treated with whole-brain radiotherapy, depending on the age, performance status and wish of the patient. However, in some of these patients the multiple brain tumors represent multifocal glioma rather than metastases, resulting in incorrect treatment. In such cases, various MRI characteristics may be helpful in directing towards the correct diagnosis. Thus, patients who present with multiple brain tumors should not always be considered to have metastatic disease even if they have a previous diagnosis of systemic cancer, and multifocal glioma should be ruled out.

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“…However, in high-grade glioma, remote cutaneous metastasis [8–10], or metastatic seeding through the stereotactic biopsy tract [11–14] have been reported. The presumed mechanism includes seeding of tumor cells during surgery [13], especially, when the biopsy tract was not included in the irradiated volume [14].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous tumor seeding after biopsy in gliomatosis cerebri

2011

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We observed a patient with subcutaneous seeding from gliomatosis cerebri with a low-grade histopathology. A 33-year-old woman with neurofibromatosis type 1 presented with progressive headache, diplopia, dysphagia, and a rightward instability. On neurological examination dysarthria, gait ataxia, and left-sided central facial and hypoglossal palsies were determined. MRI of the brain demonstrated diffuse, infiltrative non-enhancing lesions in the pons, both cerebellar hemispheres, the parahippocampal gyrus, and the thalamus. A stereotactic biopsy demonstrated an astrocytoma WHO grade 2. These characteristics confirmed gliomatosis cerebri. Three months later, the patient presented with hydrocephalus and a subcutaneous swelling directly underneath the surgical scar. The subcutaneous swelling was removed and the hydrocephalus was treated by ventriculoperitoneal shunting. Histopathological examination confirmed a subcutaneous manifestation of low-grade oligoastrocytoma. Gliomatosis cerebri with low-grade histology can seed subcutaneously.

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Multifocal Glioblastoma with Remote Cutaneous Metastasis: A Case Report and Review of the Literature

Cited by 27 publications

References 24 publications

Metastatic glioblastoma: case presentations and a review of the literature

Metastatic glioblastoma: case presentations and a review of the literature

Diagnosis and Management of Multifocal Gliomas

Subcutaneous tumor seeding after biopsy in gliomatosis cerebri

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