Supratentorial glioblastoma multiforme with spinal metastases

Shah, Abhidha; Redhu, Rakesh; Nadkarni, Trimurti; Goel, Atul

doi:10.4103/0974-8237.77678

Cited by 34 publications

(16 citation statements)

References 16 publications

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“…Other authors suggest that ependymal invasion, fissuring of the ependyma due to hydrocephalus, and fragmentation of the tumor in contact with CSF are also risk factors for CSF dissemination [22]. In both patients with spinal metastases reported by Shah et al [23], primary GBM were in close proximity to the ventricles and there was ependymal enhancement in 1 patient. During surgery, the ventricles had also been opened inadvertently in both patients and this could eventually have explained the rapid dissemination to the spine according to the authors.…”

Section: Discussionmentioning

confidence: 96%

Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme

Serrano¹,

Archavlis²,

Januschek

et al. 2017

Case Rep Oncol

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Intracranial glioblastoma multiforme (GBM) constitutes the most frequent and unfortunately aggressive primary central nervous system malignancy. Despite the high tendency of these tumors to show local relapse within the brain after primary therapy, dissemination into the spinal axis is an infrequent event. If spinal metastases occur they are leptomeningeal in the vast majority of cases and always in the context of intracranial progressive disease. Spinal intramedullary metastases of intracranial GBM have rarely been described to date. We report the unique case of a young woman with subacute progressive paraparesis due to spinal intramedullary metastases of a temporal lobe GBM despite the remarkable absence of intracranial tumor relapse. The patient had undergone gross total resection of a left temporal GBM in contact with the ventricles and cisternal space followed by radio- and chemotherapy 13 months before. At the moment of diagnosis of spinal intramedullary metastases, there were no signs of intracranial tumor recurrence as revealed by MRI scans. Since a high level of suspicion may be needed to detect this rare evolution of intracranial GBM and other differential diagnoses must be ruled out at presentation, we discuss the important features of this case regarding clinical manifestation, diagnosis, surgery, and management. Furthermore, we mention possible factors that may have contributed to the development of these metastases in the context of intracranial remission.

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Section: Discussionmentioning

confidence: 96%

Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme

Serrano¹,

Archavlis²,

Januschek

et al. 2017

Case Rep Oncol

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“… 5 First reported in 1931, 3 CSF dissemination of GBM occurs in approximately 15% to 25% of GBM patients, although the accurate incidence reported in different studies ranged a lot. 6 For infratentorial GBM, the incidence was higher. Witoonpanich once reviewed 600 GBM patients in a retrospective study, and found that symptomatic CSF dissemination just occurred in 2% of them.…”

Section: Discussionmentioning

confidence: 98%

Brain Stem and Entire Spinal Leptomeningeal Dissemination of Supratentorial Glioblastoma Multiforme in a Patient during Postoperative Radiochemotherapy

et al. 2015

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Glioblastoma multiforme (GBM) is the most common primary malignancy of the central nervous system in adults. Macroscopically evident and symptomatic spinal metastases occur rarely. Autopsy series suggest that approximately 25% of patients with intracranial GBM have evidence of spinal subarachnoid seeding, although the exact incidence is not known as postmortem examination of the spine is not routinely performed.1–3 Herein, we present a rare case of symptomatic brain stem and entire spinal dissemination of GBM in a 36-year-old patient during postoperative adjuvant radiochemotherapy with temozolomide and cisplatin. Visual deterioration, intractable stomachache, and limb paralysis were the main clinical features. The results of cytological and immunohistochemical tests on the cerebrospinal fluid cells were highly suggestive of spinal leptomeningeal dissemination. After 1 month, the patient's overall condition deteriorated and succumbed to his disease. To the best of our knowledge, this is the first reported case of GBM dissemination presenting in this manner. Because GBM extracranial dissemination is rare, we also reviewed pertinent literature regarding this uncommon entity.Although metastases to spinal cord from GBM are uncommon, it is always important to have in mind when patients with a history of GBM present with symptoms that do not correlate with the primary disease pattern.

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“…Surgery may be attempted if there is a symptomatic, large metastatic deposit causing cord compression as in our case, but usually leptomeningeal metastases are not amenable to surgery due to the diffuse nature of the disease. [ 11 ] The treatment modality for these patients is mainly palliative. RT is the most commonly used treatment modality, with a total dose of 25–40 Gy.…”

Section: Discussionmentioning

confidence: 99%

Metachronous spinal metastases from supratentorial anaplastic astrocytoma

et al. 2015

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Leptomeningeal spinal metastases from supratentorial high-grade glioma are relatively rare. Authors report an unusual case of metachronous, symptomatic, dual spinal drop metastases in a 20-year-old male patient who was operated for right insular anaplastic astrocytoma 20 months earlier. Surgical decompression of the symptomatic D11-L2 drop metastasis was carried out. Histo-pathological examination revealed features suggestive of glioblastoma multiforme. Patient was advised postoperative radiotherapy. The pertinent literature is reviewed regarding this uncommon entity.

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Supratentorial glioblastoma multiforme with spinal metastases

Cited by 34 publications

References 16 publications

Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme

Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme

Brain Stem and Entire Spinal Leptomeningeal Dissemination of Supratentorial Glioblastoma Multiforme in a Patient during Postoperative Radiochemotherapy

Metachronous spinal metastases from supratentorial anaplastic astrocytoma

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