Neurosurgical Review

, Volume 33, Issue 3, pp 375–381 | Cite as

Far-distant metastases along the CSF pathway of glioblastoma multiforme during continuous low-dose chemotherapy with temozolomide and celecoxib

  • Marcel Seiz
  • Ingo Nölte
  • Ioannis Pechlivanis
  • Christian F. FreyschlagEmail author
  • Kirsten Schmieder
  • Peter Vajkoczy
  • Jochen Tuettenberg
Case Report


Glioblastoma multiforme is the most common and most malignant primary brain tumour. Prognosis after diagnosis remains poor despite recent advances in adjuvant therapy. Treatment of choice is gross surgical resection and combined radio-chemotherapy with temozolomide as chemotherapeutic agent. Experimental continuous low-dose chemotherapy with temozolomide in combination with a cyclooxygenase-2 inhibitor has shown encouraging effects on progression-free survival and overall survival in patients, but leads to a high proportion of distant recurrences. Here, we describe extreme far-distant metastases along the neural axis of glioblastoma multiforme in four patients receiving metronomic antiangiogenic chemotherapy and review the literature to discuss possible mechanisms.


Far-distant metastases Glioblastoma multiforme Antiangiogenic therapy 



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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Marcel Seiz
    • 1
  • Ingo Nölte
    • 2
  • Ioannis Pechlivanis
    • 1
  • Christian F. Freyschlag
    • 1
    • 4
    Email author
  • Kirsten Schmieder
    • 1
  • Peter Vajkoczy
    • 3
  • Jochen Tuettenberg
    • 1
  1. 1.Department of NeurosurgeryMedical Faculty of the University of HeidelbergMannheimGermany
  2. 2.Department of NeuroradiologyMedical Faculty of the University of HeidelbergMannheimGermany
  3. 3.Department of NeurosurgeryCharité UniversitätsmedizinBerlinGermany
  4. 4.Department of NeurosurgeryUniversity Hospital Mannheim, University of HeidelbergMannheimGermany

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