Oligodendroglioma presenting with intradural spinal metastases: an unusual cause of cauda equina syndrome

Fayeye, Oluwafikayo; Sankaran, Vijay G.; Sherlala, Khaled; Choksey, M. S.

doi:10.1016/j.jocn.2009.05.029

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…Despite the above theories, glioma does metastasize outside the CNS, and most cases of extraneural metastasis (nearly 96%) have occurred after surgical excision of the primary tumor [24]. The most common glioma to metastasize is glioblastoma multiforme, followed by medulloblastoma and ependymoma [4], while OGD metastasizes very rarely.…”

Section: Discussionmentioning

confidence: 99%

Occipital anaplastic oligodendroglioma with multiple organ metastases after a short clinical course: a case report and literature review

Zhang

et al. 2014

Diagn Pathol

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BackgroundIt is generally believed that malignant gliomas never metastasize outside the central nervous system (CNS). However, the notion that oligodendrogliomas (OGDs) cells cannot spread outside CNS is being challenged.MethodsWe described in detail the clinical story of one patient with anaplastic OGD, which metastasized to lymph nodes, bone marrowand bones Genetic analyses included detection of 1p and 19q chromosomal arms, methylation status of MGMT promoter, and PTEN exon mutations. A search of worldwide literature was conducted for reports of metastatic OGDs using NCBI-PubMed, with the keywords “extracranial”, “extraneural”, “oligodendroglioma”, “oligodendrogliomas”, “metastatic”, “metastasis”, and “metastases”, in different combinations.ResultsAn open biopsy of the infiltrated bones in our patient revealed that malignant cells had replaced the patient’s marrow. Moreover, the diagnosis of multiple-organ metastases of anaplastic OGD was confirmed based on immunohistochemical staining. Genetic analyses showed that the tumors originated from previously resected brain lesions. None of the lesions had 1p and 19q deletions, but hypermethylation of MGMT promoter, and the G → A transversion at codon 234 of PTEN exon 2 were detected. Literatures review yielded 60 reports of metastatic OGDs from 1951 to the present, which with our patient makes 61 cases. Concerning these 61 patients, there were 110 infiltrated sites correlated closely with primary OGDs. The most frequent metastatic sites were bone and bone marrow (n = 47; 42.7%), lymph nodes (n = 22; 20.0%), liver (n = 7; 6.4%), scalp (n = 6; 5.5%), lung (n = 6; 5.5%), pleura (n = 4; 3.6%), chest wall (n = 3; 2.7%), iliopsoas muscle (n = 2; 1.8%), soft tissue (n = 2; 1.8%), and parotid gland (n = 2; 1.8%).ConclusionsExtracranial metastases in anaplastic OGD are very rare but they do occur; bone and bone marrow may be the most common sites. Detection of certain molecular markers such as deletion of 1p and 19q chromosomal arms, hypermethylation of MGMT promoter, and characteristic PTEN exon mutations may help differentiate subtypes which are more prone to extracranial metastases.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8749838611478560.

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Section: Discussionmentioning

confidence: 99%

Occipital anaplastic oligodendroglioma with multiple organ metastases after a short clinical course: a case report and literature review

Zhang

et al. 2014

Diagn Pathol

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“…3,14 The proximity of the tumour to the ventricles is another determinant of its ability to spread through the CSF space. 18 The patient in this report possessed all of these features. …”

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confidence: 59%

Intracavernous sinus arachnoid cyst with optic neuropathy

Cheng

Cho

Chen

et al. 2010

Journal of Clinical Neuroscience

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“…However, the use of presurgical whole-body FDG PET/CT in primary brain tumors is limited, either because presurgical MR imaging performed well or ECMs are not taken into account due to the scarcity of this event. Without that information, it is not possible to exclude spontaneous distant metastasis of primary brain tumor, [7,13–15] and it is difficult to know the exact time of the presence of ECM. Further and detailed investigation of presurgical evaluation in ECMs with whole-body FDG PET/CT imaging (including brain) is required in our future study.…”

Section: Discussionmentioning

confidence: 99%

Extracranial bone metastases from recurrent anaplastic astrocytoma on FDG PET/CT

Li¹,

2017

Medicine

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Objective:Extracranial bone metastases from astrocytoma are rare and frequently detected as part of multiorgan metastases. It is extremely rare for astrocytoma to have extracranial bone metastases alone. The importance of whole-body fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging in evaluating extracranial metastasis (ECMs) has not been described effectively due to the rarity of this event. The purpose of our case report is to emphasize the role of FDG PET/CT in the assessment of tumor recurrence and extracranial bone metastases from anaplastic astrocytoma.Methods and materials:A 25-year-old woman was firstly admitted with a 4-month history of progressive blurred vision, and 2-month history of intermittent headache. Presurgical MRI imaging revealed a large mass in the left trigone of lateral ventricle. Subsequently, she underwent tumor resection, radiotherapy and chemotherapy. A final pathological diagnosis of anaplastic astrocytoma (WHO III) was made. Nearly 12 months after the surgery, the follow-up brain MR imaging revealed a contrast-enhanced lesion in the site of operative region. Whole-body FDG PET/CT imaging was performed to evaluate the situation.Results:Postoperative brain FDG PET/CT showed an abnormal focal FDG uptake corresponding to the contrast-enhanced lesion in the operative area, suggesting a tumor recurrence. Whole-body FDG PET/CT also showed multiple FDG-avid osteosclerotic lesions in the body. It was highly suggestive of extracranial bone metastases. A subsequent open bone biopsy of FDG-avid lesion in right iliac crest was performed. Histopathological and immunohistochemical findings indicated characteristic of glioma. The patient died 1 month later, nearly 13 months after the initial diagnosis.Conclusions:ECMs from anaplastic astrocytoma are extremely rare but they do occur. Whole-body FDG PET/CT imaging with inclusion of brain was valuable in differentiating tumor recurrence from radiation necrosis and in detecting uncommon extracranial bone metastases from anaplastic astrocytoma, which were closely related to prognosis of this disease.

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Oligodendroglioma presenting with intradural spinal metastases: an unusual cause of cauda equina syndrome

Cited by 8 publications

References 16 publications

Occipital anaplastic oligodendroglioma with multiple organ metastases after a short clinical course: a case report and literature review

Occipital anaplastic oligodendroglioma with multiple organ metastases after a short clinical course: a case report and literature review

Intracavernous sinus arachnoid cyst with optic neuropathy

Extracranial bone metastases from recurrent anaplastic astrocytoma on FDG PET/CT

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