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Knittel R, Rogers S, Wood BA. Cutaneous Seeding of Glioblastoma: A Case Report and Literature Review. Am J Dermatopathol 2024; 46:685-689. [PMID: 38842394 DOI: 10.1097/dad.0000000000002748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
ABSTRACT We present the case of a 61-year-old male patient with a history of intracranial IDH-wildtype glioblastoma with an isolated cutaneous metastasis within the previous surgical site scar. The cytomorphology of the cutaneous deposits was reminiscent of metastatic melanoma, which is a differential diagnostic pitfall. The tumor molecular characteristics are described, as these have become essential diagnostic criteria for many central nervous system tumors, along with a discussion of the role of immunohistochemical markers and potential pitfalls in the differential diagnosis of melanoma and poorly differentiated carcinoma. We discuss the biology of metastatic glioblastoma and provide a focused literature review of previous glioblastomas with tumor cell seeding within prior surgical scars.
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Affiliation(s)
- Ronan Knittel
- Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia; and
| | - Sasha Rogers
- Neurosurgery Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Benjamin A Wood
- Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia; and
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2
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Wang F, Dong J, Zhang J, Zhao H, Wang N, Jin J, Yan X, Gao X, Liu H, Hu S. Rapid progression of subcutaneous glioblastoma: A case report and literature review. Front Oncol 2023; 13:935944. [PMID: 36761958 PMCID: PMC9905810 DOI: 10.3389/fonc.2023.935944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Extra-neural spread of glioblastoma (GBM) is extremely rare. We report a case of postoperative intracranial GBM spreading to the subcutaneous tissue via the channel of craniotomy defect in a 73-year-old woman. Radiological images and histopathology indicate that the tumor microenvironment of the subcutaneous tumor is clearly different from the intracranial tumor. We also model the invasion of GBM cells through the dura-skull defect in mouse. The retrospective analysis of GBM with scalp metastases suggests that craniectomy is a direct cause of subcutaneous metastasis in patients with GBM. Imaging examinations of other sites for systemic screening is also recommended to look for metastases outside the brain when GBM invades the scalp or metastasizes to it.
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Affiliation(s)
- Fang Wang
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China,Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiawei Dong
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China,Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiheng Zhang
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hongtao Zhao
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Nan Wang
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiaqi Jin
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiuwei Yan
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xin Gao
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Han Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Shaoshan Hu, ; Han Liu,
| | - Shaoshan Hu
- Cancer Center, Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China,Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China,*Correspondence: Shaoshan Hu, ; Han Liu,
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3
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Zhang K, Yang Y, Zhuang J, Guo G, Chao X, Zhang Z. Intracranial dissemination of glioblastoma multiforme: a case report and literature review. J Int Med Res 2022; 50:3000605221112047. [PMID: 35854630 PMCID: PMC9310070 DOI: 10.1177/03000605221112047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intracranial dissemination is rare among patients with glioblastoma multiforme
(GBM). Very few GBM patients develop symptoms from intracranial dissemination,
as most do not surviving long enough for intracranial dissemination to become
clinically evident. Herein, we report a case of GBM in a 39-year-old woman who
underwent surgical resection, concomitant chemoradiotherapy, and seven courses
of adjuvant chemotherapy with temozolomide. The patient then complained of an
instable gait and hearing loss. Imaging studies demonstrated that although the
primary intracranial tumors were well-controlled by treatment, contralateral
cerebellopontine angle seeding dissemination was present. The patient died 3
months after the diagnosis of seeding dissemination. In light of a previous
report and our current case, heightened awareness could promote surgical
strategies that minimize the possibility of dissemination, including avoiding
ventricular entry or a no-touch strategy.
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Affiliation(s)
- Keke Zhang
- Department of Otolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University
| | - Yihang Yang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University
| | - Jianfeng Zhuang
- Department of Neurosurgery, Qilu Hospital, Shandong University
| | - Gengyin Guo
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University
| | - Xin Chao
- Department of Neurosurgery, Second People's Hospital of Xintai
| | - Zhen Zhang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University.,State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Pharmaceutical Co., Ltd.,The First Clinical College of Shandong University of Chinese Traditional Medicine
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Noch EK, Sait SF, Farooq S, Trippett TM, Miller AM. A case series of extraneural metastatic glioblastoma at Memorial Sloan Kettering Cancer Center. Neurooncol Pract 2021; 8:325-336. [PMID: 34055380 DOI: 10.1093/nop/npaa083] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Extraneural metastasis of glioma is a rare event, often occurring in patients with advanced disease. Genomic alterations associated with extraneural glioma metastasis remain incompletely understood. Methods Ten patients at Memorial Sloan Kettering Cancer Center diagnosed with extraneural metastases of glioblastoma (9 patients) and gliosarcoma (1 patient) from 2003 to 2018 were included in our analysis. Patient characteristics, clinical course, and genomic alterations were evaluated. Results Patient age at diagnosis ranged from 14 to 73, with 7 men and 3 women in this group. The median overall survival from initial diagnosis and from diagnosis of extraneural metastasis was 19.6 months (range 11.2 to 57.5 months) and 5 months (range 1 to 16.1 months), respectively. The most common site of extraneural metastasis was bone, with other sites being lymph nodes, dura, liver, lung, and soft tissues. All patients received surgical resection and radiation, and 9 patients received temozolomide, with subsequent chemotherapy appropriate for individual cases. 1 patient had an Ommaya and then ventriculoperitoneal shunt placed, and 1 patient underwent craniectomy for cerebral edema associated with a brain abscess at the initial site of resection. Genomic analysis of primary tumors and metastatic sites revealed shared and private mutations with a preponderance of tumor suppressor gene alterations, illustrating clonal evolution in extraneural metastases. Conclusions Several risk factors emerged for extraneural metastasis of glioblastoma and gliosarcoma, including sarcomatous dedifferentiation, disruption of normal anatomic barriers during surgical resection, and tumor suppressor gene alterations. Next steps with this work include validation of these genomic markers of glioblastoma metastases in larger patient populations and the development of preclinical models. This work will lead to a better understanding of the molecular mechanisms of metastasis to develop targeted treatments for these patients.
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Affiliation(s)
- Evan K Noch
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sameer F Sait
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shama Farooq
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Tanya M Trippett
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alexandra M Miller
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Turk O, Ozdemir NG, Atci IB, Yilmaz H, Gunver F, Antar V, Yilmaz A. A rare case of cervical metastatis of glioblastoma after cranial tumor resection: case report and review of literature. Br J Neurosurg 2020; 35:341-347. [PMID: 32870037 DOI: 10.1080/02688697.2020.1814994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Glioblastoma multiforme (GBM) is the most common and the most malignant primary intracranial tumor in adults. GBM extraneural metastases occur in only approximately 0.2-0.4% of patients. We present a case of a cervical metastasis of glioblastoma after cranial tumor resection. In concord with case presentation, we reviewed the metastatic location and metastasis time of the gliablastomas seen in the literature.
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Affiliation(s)
- Okan Turk
- Department of Neurosugery, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Nuriye Guzin Ozdemir
- Department of Neurosugery, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim Burak Atci
- Department of Neurosugery, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Hakan Yilmaz
- Department of Neurosurgery, Usak University Education and Research Hospital, Usak, Turkey
| | - Feray Gunver
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Veysel Antar
- Department of Neurosugery, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Adem Yilmaz
- Department of Neurosugery, Istanbul Education and Research Hospital, Istanbul, Turkey
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Rennert RC, Hoshide RR, Signorelli JW, Amaro D, Sack JA, Brennan CW, Chen CC. Concurrence of chromosome 6 chromothripsis and glioblastoma metastasis. J Neurosurg 2017; 126:1472-1478. [DOI: 10.3171/2016.4.jns153052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report an unusual case of a widely metastatic glioblastoma. DNA copy number microarray profile of the resected specimen revealed complex rearrangements found throughout chromosome 6, a phenomenon known as chromothripsis. Such chromothripsis pattern was not observed in 50 nonmetastatic glioblastoma specimens analyzed. Analysis of the 1000+ gliomas profiled by The Cancer Genome Atlas (TCGA) data set revealed one case of chromosome 6 chromothripsis resembling the case described here. This TCGA patient died within 6 months of undergoing tumor resection. Implications of these findings are reviewed in the context of the current literature.
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Affiliation(s)
| | | | | | - Deirdre Amaro
- 2Pathology, University of California, San Diego, California; and
| | | | - Cameron W. Brennan
- 3Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York
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