Acta Neurochirurgica

, Volume 35, Issue 4, pp 247–259 | Cite as

Extracranial metastases of anaplastic cerebral gliomas

  • H. Schuster
  • K. Jellinger
  • A. Gund
  • H. Reǵele
Case Reports


Seven cases are reported of anaplastic cerebral gliomas with metastases outside the neuraxis, seen among about 1500 gliomas. There were two children with anaplastic ependymomas, one adult with oligodendroglioma, and four young to middle-aged adults with astrocytomas grade III and IV. All patients had one or more craniotomies, and four had radiotherapy prior to the appearance of distant tumour deposits. The survival times ranged from 7 to 31 months in cases with gliomas grade II, and from 8 to 18 months with high grade astrocytomas. All seven tumours showed invasion of the meninges, ventricular walls, or both, and in four cases they transgressed the dura and surrounding bone or soft tissues. In six autopsy cases there was widespread dissemination of gliomas through the CSF pathways. Distant metastases involved regional or distant lymph nodes in six patients, the lungs in two, and the vertebrae, pleura, liver, or mediastinum in one patient each. The possible pathways for distant spread of intracranial gliomas and the factors which are considered responsible are briefly discussed.


  1. Anzil, A. P., Glioblastoma multiforme with extracranial metastases in the absence of previous craniotomy. Case report. J. Neurosurg.33 (1970), 88–94.PubMedGoogle Scholar
  2. Bogdanovich, N. K., K voprosu o metastaziruyushchikh opukholyakh golovnagu mozgu. Arkh. Path. (Moskau)20 (1958), 83–86.Google Scholar
  3. Brander, W. L., Turner, D. R., Extracranial metastases from a glioma in the absence of surgical intervention. J. Neurol. Psychiat. Neurosurg.38 (1975), 1133–1135.Google Scholar
  4. Brust, J. C. M., Moiel, R. H., Rosenberg, R. N., Glial tumor metastases through a ventriculo-pleural shunt. Arch. Neurol. (Chic.)18 (1968), 649–653.Google Scholar
  5. Cappelaere, P., Cla, A., Adenis, L., Demaille, A., Laine, E., Les métastases des tumeurs cérébrales primitives en dehors du névraxe. Bull. Cancer59 (1972), 235–254.PubMedGoogle Scholar
  6. Dolman, C. L., Lymph node metastasis as first manifestation of glioblastoma. J. Neurosurg.41 (1974), 607–609.PubMedGoogle Scholar
  7. Eade, O. E., Urich, H., Metastasizing gliomas in young subjects. J. Path. (Edinbg.)103 (1971), 245–256.Google Scholar
  8. El-Gindi, S., Salama, M., El-Henawy, M., Farag, S., Metastases of glioblastoma multiforme to cervical lymph nodes. J. Neurosurg.38 (1973), 631–634.PubMedGoogle Scholar
  9. Fisher, E. R., Fisher, B., Immunologic factors in experimental metastases formation. Int. J. Radiol. Oncol.1 (1975), 87–92.Google Scholar
  10. Földi, M., Physiologie und Pathophysiologie des Lymphgefäßsystems. In: Alt-mann, H.-W.,et al. (eds.): Handbuch der allgemeinen Pathologie, Vol. III, Part 6, pp. 239–310. Berlin-Heidelberg-New York: Springer. (1972).Google Scholar
  11. Gropp, A., Über ein metastasierendes „Gliom“. Z. Krebsforsch.60 (1955), 590–596.PubMedGoogle Scholar
  12. Højgaard, K., Johansen, A., A case of ependymoma with remote metastasis. Acta path, microbiol. scand. Suppl.212 (1970), 198–200.Google Scholar
  13. Jellinger, K., Minauf, M., Salzer-Kuntschik, M., Oligodendroglioma with extraneural metastases. J. Neurol. Psychiat. Neurosurg.32 (1969), 249–253.Google Scholar
  14. Komatsu, K., Inaba, Y., Hiratsuka, H., Extensive extra-cranial metastases of glioblastoma multiforme. Brain Nerve (Tokyo)14 (1972), 339–351.Google Scholar
  15. Koos, W. T., Miller, M., Intracranial tumors of infants and children. Stuttgart: G. Thieme. 1971.Google Scholar
  16. Kretschmer, H., Die extrakranielle Metastasierung intrakranieller Geschwülste. Zbl. Neurochir.35 (1974), 81–112.Google Scholar
  17. Kung, P. C., Lee, J. C., Bakay, L., Vascular invasion by glioma cells. An electron microscopic study. J. Neurosurg.31 (1969), 339–345.PubMedGoogle Scholar
  18. Minauf, M., Jellinger, K., Meningeales Wachstum von Oligodendrogliomen. Acta Neurochir. (Wien)19 (1968), 269–280.Google Scholar
  19. Morley, T. P., The recovery of tumour cells from venous blood draining cerebral gliomas. A preliminary report. Can. J. Surg.2 (1959), 363–365.PubMedGoogle Scholar
  20. Mracek, Z., Janda, J., Glioblastoma multiforme s extrakranialnimi metastazami. Cs. Neurol. Neurochir.38 (1975), 19–24.Google Scholar
  21. Pe, K. M., Oligodendroglioma with extracranial metastases. Zhong Waike Z.11 (1962), 635–637.Google Scholar
  22. Ridley, A., Immunological reactions to gliomas. In: D. Williams, ed., Modern trends in Neurology, Vol. 6, p. 249–266. London: Butterworths. (1975).Google Scholar
  23. Rubinstein, L. J., Extracranial metastases from a malignant astrocytoma in the absence of previous craniotomy. J. Neurosurg.26 (1967), 542–547.PubMedGoogle Scholar
  24. —, Tumors of the central nervous system. Atlas of Tumor Pathology, 3rd edit., Fasc. 6. Washington, D.C.: Armed Forces Institute of Pathology. (1972).Google Scholar
  25. Smith, D. R., Hardman, J. M., Earle, K. M., Metastasizing neuroectodermal tumors of the central nervous system. J. Neurosurg.31 (1969), 50–58.PubMedGoogle Scholar
  26. Wakamatsu, T., Extracranial metastasis of intracranial tumor. Acta path. jap.22 (1974), 155–169.Google Scholar
  27. —, Matsuo, T., Kawano, S., Teratomo, S., Watsumara, H., Glioblastoma with extracranial metastasis through ventriculopleural shunt. J. Neurosurg.34 (1971), 697–701.PubMedGoogle Scholar
  28. Weiss, L., A metastasizing ependymoma of the cauda equina. Cancer8 (1955), 161–171.PubMedGoogle Scholar
  29. Willis, R. A., The spread of tumors in the human body. 3rd ed. London: Butterworths. (1973).Google Scholar
  30. Wolf, A., Cowen, D., Stewart, W. B., Glioblastoma with extracranial metastasis by way of a ventriculopleural anastomosis. Trans. Amer. Neurol. Ass.79 (1954), 140–142.Google Scholar
  31. Zeitelhofer, J., Kraus, H., Über die extrakranielle Metastasierung der Gliome. Zbl. Neurochir.12 (1952), 347–358.Google Scholar
  32. Zimmerman, H. M., An explanation of certain glioma problems. J. Mt. Sinai Hosp.24 (1957), 1357–1362.Google Scholar

Copyright information

© Springer-Verlag 1976

Authors and Affiliations

  • H. Schuster
    • 1
    • 2
  • K. Jellinger
    • 1
    • 2
  • A. Gund
    • 1
    • 2
  • H. Reǵele
    • 1
    • 2
  1. 1.Department of Neurosurgery and Division of Special NeuropathologyNeurological Institute of the University of ViennaAustria
  2. 2.Departments of Neurosurgery and PathologyWagner-Jauregg-HospitalLinzAustria

Personalised recommendations