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Spinal and cervical nodal metastases in a patient with glioblastoma

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Abstract

This article presents the rare case of a 54-year-old gentleman with primary glioblastoma developing multiple extracranial metastases 7 months after diagnosis. Initially, the patient complained of progressive headaches, confusion, and weakness of the left arm. Magnetic resonance imaging of the brain showed a right temporoparietal tumor with substantial surrounding subcortical edema and midline shift to the left. Two consecutive craniotomies resulted in complete microsurgical resection of the lesion. Histology was consistent with a World Health Organization grade IV, IDH-wildtype glioblastoma. Further treatment was standard chemoradiation including intensity-modulated radiotherapy with oral temozolomide chemotherapy. Seven months after diagnosis, the cranial lesion progressed, and the patient developed painful metastases in multiple bones and suspicious right-sided cervical lymph nodes. Immunohistochemistry and molecular signature supported the case of a metastatic glioblastoma. Further treatment was palliative radiotherapy of the spinal lesions along with symptomatic pain management. Extracranial metastasis of glioblastoma is a rare complication of which only a few cases have been reported in the literature. Little is known about the precise mechanisms of tumor dissemination and the appropriate treatment.

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Data Availability Statement

Data are available and can be accessed via the email address of the senior author.

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Funding

This study was not supported by any sponsor or funder.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Coburg Cancer Center, Coburg, Germany

    Silvio Heinig & Gerhard G. Grabenbauer

  2. Department of Molecular Pathology, Coburg Cancer Center, Coburg, Germany

    Thomas Aigner

  3. Department of Neurosurgery, Coburg Cancer Center, Lichtenfels, Germany

    Heinz-Georg Bloß

  4. University of Split School of Medicine, Split, Croatia

    Silvio Heinig & Gerhard G. Grabenbauer

Authors
  1. Silvio Heinig
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  2. Thomas Aigner
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  3. Heinz-Georg Bloß
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  4. Gerhard G. Grabenbauer
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Contributions

S. Heinig and G.G. Grabenbauer wrote and refined the paper. T. Aigner performed the pathologic examination and provided Fig. 1. H.-G. Bloß contributed to writing the paper and performed surgery. All authors approved the final version of the paper.

Corresponding author

Correspondence to Gerhard G. Grabenbauer.

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Conflict of interest

S. Heinig, T. Aigner, H.-G. Bloß and G.G. Grabenbauer declare that they have no competing interests.

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Written informed consent was obtained from relatives for publication of the details of their medical case and any accompanying images.

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Heinig, S., Aigner, T., Bloß, HG. et al. Spinal and cervical nodal metastases in a patient with glioblastoma. Strahlenther Onkol (2024). https://doi.org/10.1007/s00066-024-02214-w

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