Extracranial growth of glioblastoma multiforme

摘要: We present a 59-year-old woman who noted an enlarging lump on her forehead 6 months after left frontotemporal craniotomy for tumor resection and chemoradiation of primary glioblastoma multiforme (GBM). GBM is highly aggressive intracranial neoplasm associated with the shortest survival time any central nervous system malignancy. Extracranial metastasis rare, especially without previous surgical disruption dura calvarium, which has been postulated to cause seeding extracranial space cells. This patient’s MRI revealed recurrence she underwent repeat resection. Histopathology confirmed unmethylated O-6-methylguanine-DNA methyltransferase wildtype isocitrate dehydrogenase 1 status, as well invasion through bone subdermal space. The genetic molecular factors that predict remain unclear require further investigation. Emerging data circulating cells in patients indicate extraaxial may be part disease course some, particularly long term survivors. Furthermore, proximity calvarial scalp lesions sites they emerge surgery suggests iatrogenic also play role metastasis. With heightened awareness phenomenon, strategies such watertight approximation dura, flap replacement, or changing instruments once intradural component complete prove useful prevent seeding. Prophylactic craniospinal irradiation appropriate tool at high risk metastasis, although this population difficult identify.