Extracranial metastasis of anaplastic oligoastrocytoma

Extracranial metastasis(ECM) of glioma is a rare condition that occurs in the internal nervous axis. A 23-year-old woman presented with anaplastic oligoastrocytoma(WHO III) in a left temporal tumor. The patient received chemoradiotherapy after surgery in our center. Three years after treatment, the patient experienced multiple ECMs in the right lung, left iliac bone, and multiple swollen subcutaneous nodules including the right clavicle, back of the neck, left forearm, right upper arm, and right clavicle. The patient died of cerebral herniation at the age of 27 due to recurrent intracranial glioma. Treatment of ECM of glioma remains very challenging, and further investigations are needed.

Postoperative glioma extracranial metastasis:A case report

A case with intracranial glioma after the surgery metastasizing to the spine was described. A 28-year-old female patient who underwent surgery and radiation therapy for glioma in the left frontal lobe and was diagnosed as having extracranial metastasis to L2–L4 vertebral body by MRI, PET-CT and pathological examination. The clinical, imaging and pathologic features of the case are described and discussed.

Extracranial multiorgan metastasis from primary glioblastoma: A case report

BACKGROUND Glioblastoma has a high degree of malignancy and poor prognosis.It is common to have in situ recurrence and intracranial metastasis,while extracranial metastasis is rare,and extracranial multiorgan metastasis is extremely rare.We report a case of glioblastoma with extracranial multiorgan metastasis,which will strengthen clinicians’attention to the extracranial metastasis of glioblastoma and its treatment.CASE SUMMARY A male patient visited our hospital for treatment of dizziness and headache.Magnetic resonance imaging of the brain revealed a space-occupying lesion in the right temporoparietal occipital region.Chest computed tomography and abdominal ultrasound were normal,and no space-occupying lesions were observed in other organs of the body.The patient underwent surgery and diagnosed with glioblastoma.Postoperative concurrent radiotherapy and chemotherapy were completed.During the follow-up,the tumor was found to have metastasized to the scalp and neck,and a second tumor resection was performed.Postoperative follow-up revealed extracranial metastases to multiple extracranial organs including skull,scalp,ribs,spine,liver and lung.His family members refused further treatment,and requested only symptomatic treatment such as pain relief,and the patient died of systemic multiple organ failure.Survival time from diagnosis to death was 13 mo and from extracranial metastasis to death was 6 mo.CONCLUSION Glioblastoma extracranial metastasis is extremely rare,clinicians should always pay attention to its existence.The mechanism of glioblastoma extracranial metastasis is still unclear,and genetic and molecular studies are required.

Primary gliosarcoma with widespread extracranial metastases--spatiotemporal morphological variation

Background:We summarize 5 cases of primary gliosarcoma with widespread extracranial metastases including our case.The glial components are eliminated due to the needs of the living environment in the process of parasitism and survival of brain glioma-sarcoma cells in lung metastasis.Methods:A PubMed search using the keywords"gliosarcoma"and"extracranial metastases"was performed followed by a review of cited literature.Our case was a 50-year-old female presented with headache and dizziness.MRI examination showed that there was a cystic solid tumor in the right temporal lobe.The tumor was removed totally.Seven months after the operation,the patient suffered recurrent intermittent headache.The resection for the recurrent tumor was performed.Postoperative pathology confirmed the recurrent gliosarcoma.A needle biopsy was performed for the nodular on the right lung.The lung tumor pathology suggested a sarcoma structure.Results:There was a female patient in five cases.The age range is 47 to 69 years old.The tumor recurred within a year.A combination of treatment modalities may extend survival;however,the prognosis remains poor.Conclusion:Primary gliosarcoma with extracranial metastases is extremely rare.Some findings uncovered an unexpected spatiotemporal morphological variation in the different foci of the same malignancy.

Somatic mutation landscape of a meningioma and its pulmonary metastasis

Background:Extracranial metastasis(ENM)of meningiomas is extremely rare,and typically occurs several years after a primary tumor is diagnosed.However,the genetic changes underlying ENM events have not yet been investigated.Case presentation:A 58-year-old male patient was sent to the emergency room of our hospital because of a sudden fall.Magnetic resonance imaging detected a mass at the right frontal sagittal sinus.He underwent tumor resection and recovered well,but post-operative computed tomography revealed three lumps on the right side of his chest.Thoracic surgery was performed to remove two of the lumps.Pathological findings revealed that the brain and lung tumors were grade I meningiomas.The patient received no additional radiation or chemotherapy post-surgery,and there was no sign of tumor recurrence in the brain or progression of the remaining lump in the chest 1 year after surgery.We performed whole exome sequencing of the patient’s blood,primary brain tumor,and lung metastatic tumor tissues to identify somatic genetic alterations that had occurred during ENM.This revealed that a frameshift deletion of the neurofibromin 2 gene likely drove formation of the meningioma.Surprisingly,we found that the brain tumor was relatively homogeneous and contained only one dominant clone;both the pulmonary metastasis and the original brain tumor were derived from the same clone,and no obvious additional driver mutations were detected in the metastatic tumor.Conclusion:Although ENM of meningiomas is very rare,brain tumor cells appear to be more adaptable to tissue microenvironments outside of the central nervous system than was commonly thought.