Intracranial Glioblastoma with Drop Metastases to the Spine After Stereotactic Biopsy

Abstract

Background Glioblastoma (GBM) is the most common primary intracranial tumor, but metastases are rarely reported. Previous reports have documented the occurrence of drop metastases to the spine. However, few of these reports have demonstrated the occurrence of spinal metastases after biopsy with stable intracranial disease. Here we present such a case.

Case Description We present a case of GBM metastatic to the spinal cord after a stereotactic biopsy with stable intracranial disease. To our knowledge, this occurrence has only been reported in one previous case.

Conclusion We propose that traversing the lateral ventricle at the time of biopsy contributed to cerebrospinal fluid seeding with tumor cells and subsequent development of spinal disease.

Keywords

glioblastoma - GBM - metastasis - spine

• References

• 1 Alatakis S, Malham GM, Thien C. Spinal leptomeningeal metastasis from cerebral glioblastoma multiforme presenting with radicular pain: case report and literature review. Surg Neurol 2001; 56 (1) 33-37 , discussion 37–38
• 2 Hamilton MG, Tranmer BI, Hagen NA. Supratentorial glioblastoma with spinal cord intramedullary metastasis. Can J Neurol Sci 1993; 20 (1) 65-68
• 3 Karaca M, Andrieu MN, Hicsonmez A, Guney Y, Kurtman C. Cases of glioblastoma multiforme metastasizing to spinal cord. Neurol India 2006; 54 (4) 428-430
• 4 Lam CH, Cosgrove GR, Drislane FW, Sotrel A. Spinal leptomeningeal metastasis from cerebral glioblastoma. Appearance on magnetic resonance imaging. Surg Neurol 1991; 35 (5) 377-380
• 5 Lindsay A, Holthouse D, Robbins P, Knuckey N. Spinal leptomeningeal metastases following glioblastoma multiforme treated with radiotherapy. J Clin Neurosci 2002; 9 (6) 725-728
• 6 Maiuri F, Benvenuti D, Gangemi M, Corriero G, Giamundo A, De Chiara A. Spinal subarachnoid metastasis from primary intracranial gliomas. Acta Neurol (Napoli) 1980; 2 (5) 399-405
• 7 Onda K, Tanaka R, Takeda N. Spinal metastases of cerebral glioblastoma: the value of computed tomographic metrizamide myelography in the diagnosis. Surg Neurol 1986; 25 (4) 399-405
• 8 Pohar S, Taylor W, Chandan VS, Shah H, Sagerman RH. Primary presentation of glioblastoma multiforme with leptomeningeal metastasis in the absence of previous craniotomy: a case report. Am J Clin Oncol 2004; 27 (6) 640-641
• 9 Schwaninger M, Patt S, Henningsen P, Schmidt D. Spinal canal metastases: a late complication of glioblastoma. J Neurooncol 1992; 12 (1) 93-98
• 10 Scoccianti S, Detti B, Meattini I , et al. Symptomatic leptomeningeal and intramedullary metastases from intracranial glioblastoma multiforme: a case report. Tumori 2008; 94 (6) 877-881
• 11 Erlich SS, Davis RL. Spinal subarachnoid metastasis from primary intracranial glioblastoma multiforme. Cancer 1978; 42 (6) 2854-2864
• 12 Onda K, Tanaka R, Takahashi H, Takeda N, Ikuta F. Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 1989; 25 (4) 533-540
• 13 Elliott JP, Keles GE, Waite M, Temkin N, Berger MS. Ventricular entry during resection of malignant gliomas: effect on intracranial cerebrospinal fluid tumor dissemination. J Neurosurg 1994; 80 (5) 834-839
• 14 Fecteau AH, Penn I, Hanto DW. Peritoneal metastasis of intracranial glioblastoma via a ventriculoperitoneal shunt preventing organ retrieval: case report and review of the literature. Clin Transplant 1998; 12 (4) 348-350
• 15 Newton HB, Rosenblum MK, Walker RW. Extraneural metastases of infratentorial glioblastoma multiforme to the peritoneal cavity. Cancer 1992; 69 (8) 2149-2153
• 16 Pierallini A, Caramia F, Piattella MC , et al. Metastasis along the stereotactic biopsy trajectory in glioblastoma multiforme. Acta Neurochir (Wien) 1999; 141 (9) 1011-1012
• 17 Steinmetz MP, Barnett GH, Kim BS, Chidel MA, Suh JH. Metastatic seeding of the stereotactic biopsy tract in glioblastoma multiforme: case report and review of the literature. J Neurooncol 2001; 55 (3) 167-171
• 18 Aichholzer M, Mazal PR, Haberler C , et al. Epidural metastasis of a glioblastoma after stereotactic biopsy: case report. Minim Invasive Neurosurg 2001; 44 (3) 175-177
• 19 Bouillot-Eimer S, Loiseau H, Vital A. Subcutaneous tumoral seeding from a glioblastoma following stereotactic biopsy: case report and review of the literature. Clin Neuropathol 2005; 24 (6) 247-251