Abstract
Extracranial metastases from glioblastoma multiforme (GBM) are rare, especially cutaneous metastasis. However, the metastatic mechanism of GBM remains unknown with no current consensus regarding the best therapeutic regimen. We report the clinical, imaging and pathological features of a case of a 47 years old man with primary glioblastoma; who 12 months after receiving a macroscopically total resection and adjacent radiotherapy, developed scalp metastasis and subsequent multiple skin metastasis. We also discuss the details of this case in comparison with the previously reported cases in literature in terms of clinical presentation, lesions’ site, management and survival.
Highlights
Extracranial metastases of glioblastoma are considered a rare entity with an incidence of 0.2 to 2% [1]
We report the clinical, imaging and pathological features of a case of a 47 years old man with primary glioblastoma; who 12 months after receiving a macroscopically total resection and adjacent radiotherapy, developed scalp metastasis and subsequent multiple skin metastasis
Around twenty cases of skin metastases from glioblastoma have been published until 2020. we can observe that skin and soft tissue metastases of glioblastoma multiforme (GBM) have occurred at the site of the craniotomy or the stereotaxic biopsy, and it appears that the presence of skin and soft tissue metastases is concomitant with intracranial recurrence; it is not known whether the surgical technique plays a role in the dissemination or not
Summary
Extracranial metastases of glioblastoma are considered a rare entity with an incidence of 0.2 to 2% [1]. Case report: We report the case of a 47-year-old man with a history of arterial hypertension under treatment, who presented with memory disorders associated to visual loss evolving since 02 months; A cerebral MRI showed an intra-axial left fronto-parietal lesion suggesting a glial tumor; A macroscopically total resection was performed; the anatomopathological examination revealed a grade VI glioblastoma according to WHO classification; Afterwards the patient benefited from 30 sessions of radiotherapy (60gy), post-radiation MRI showed a recurrence of the fronto-parietal process of 68.8mm in diameter. The cerebrospinal MRI revealed an advanced left frontal lobar glioblastoma, presenting a significant extension to the scalp; to the external auditory canal and the salivary glands through the craniotomy flap; with bilateral cervical lymph node invasion, left para-vertebral superficial muscle nodule secondary appearance; and osteolytic lesions of the vertebral body of T7 lateralized to the right and superomedial of the body of L2 (figure 4); Figure 4: The cerebrospinal MRI showing multiple lesions. Palliative treatment was undertaken; the patient succumbs to the endocranial and exocranial progression of the glioblastoma, 16 months after the first diagnosis of glioblastoma and 04 months after the appearance of extra cranial metastases
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