Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology
BackgroundGlioblastoma is a malignant tumor, and its prognosis is as poor as 1.5 to 2 years. Most cases recur within one year even under the standard treatment. The majority of recurrences are local, and in rare cases, metastasize mostly within the centra nervous system. Extradural metastasis of gli...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1101552/full |
| _version_ | 1797904789476999168 |
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| author | Ako Matsuhashi Shota Tanaka Hirokazu Takami Masashi Nomura Masako Ikemura Yoshitaka Matsubayashi Yusuke Shinoda Keisuke Yamada Yu Sakai Yasuaki Karasawa Shunsaku Takayanagi Nobuhito Saito |
| author_facet | Ako Matsuhashi Shota Tanaka Hirokazu Takami Masashi Nomura Masako Ikemura Yoshitaka Matsubayashi Yusuke Shinoda Keisuke Yamada Yu Sakai Yasuaki Karasawa Shunsaku Takayanagi Nobuhito Saito |
| author_sort | Ako Matsuhashi |
| collection | DOAJ |
| description | BackgroundGlioblastoma is a malignant tumor, and its prognosis is as poor as 1.5 to 2 years. Most cases recur within one year even under the standard treatment. The majority of recurrences are local, and in rare cases, metastasize mostly within the centra nervous system. Extradural metastasis of glioma is exceedingly rare. Here, we present a case of vertebral metastasis of glioblastoma.Case presentationWe present a 21-year-old man post total resection of the right parietal glioblastoma, diagnosed with lumbar metastasis. He originally presented with impaired consciousness and left hemiplegia and underwent gross total resection of the tumor. Given the diagnosis of glioblastoma, he was treated with radiotherapy combined with concurrent and adjuvant temozolomide. Six months after tumor resection, the patient presented with severe back pain, and was diagnosed as metastatic glioblastoma on the first lumbar vertebrae. Posterior decompression with fixation and postoperative radiotherapy were conducted. He went on to receive temozolomide and bevacizumab. However, at 3 months after the diagnosis of lumbar metastasis, further disease progression was noted, and his care was transitioned to best supportive care. Comparison on copy number status between primary and metastatic lesions on methylation array analysis revealed more enhanced chromosomal instability including 7p loss, 7q gain and 8 gain in the metastatic lesion.ConclusionBased upon the literature review and our case, younger age of initial presentation, multiple surgical interventions, and long overall survival seem to be the risk factors of vertebral metastasis. As the prognosis of glioblastoma improves over time, its vertebral metastasis is seemingly more common. Therefore, extradural metastasis should be kept in mind in the treatment of glioblastoma. Further, detailed genomic analysis on multiple paired specimens is mandated to elucidate the molecular mechanisms of vertebral metastasis. |
| first_indexed | 2024-04-10T09:54:29Z |
| format | Article |
| id | doaj.art-a030dc3b61834d3bb50573acba60efec |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T09:54:29Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a030dc3b61834d3bb50573acba60efec2023-02-16T12:40:13ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-02-011310.3389/fonc.2023.11015521101552Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncologyAko Matsuhashi0Shota Tanaka1Hirokazu Takami2Masashi Nomura3Masako Ikemura4Yoshitaka Matsubayashi5Yusuke Shinoda6Keisuke Yamada7Yu Sakai8Yasuaki Karasawa9Shunsaku Takayanagi10Nobuhito Saito11Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Pathology, The University of Tokyo Hospital, Tokyo, JapanDepartment of Orthopedic Surgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Rehabilitation Medicine, Saitama Medical University Hospital, Saitama, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanDepartment of Neurosurgery, The University of Tokyo Hospital, Tokyo, JapanBackgroundGlioblastoma is a malignant tumor, and its prognosis is as poor as 1.5 to 2 years. Most cases recur within one year even under the standard treatment. The majority of recurrences are local, and in rare cases, metastasize mostly within the centra nervous system. Extradural metastasis of glioma is exceedingly rare. Here, we present a case of vertebral metastasis of glioblastoma.Case presentationWe present a 21-year-old man post total resection of the right parietal glioblastoma, diagnosed with lumbar metastasis. He originally presented with impaired consciousness and left hemiplegia and underwent gross total resection of the tumor. Given the diagnosis of glioblastoma, he was treated with radiotherapy combined with concurrent and adjuvant temozolomide. Six months after tumor resection, the patient presented with severe back pain, and was diagnosed as metastatic glioblastoma on the first lumbar vertebrae. Posterior decompression with fixation and postoperative radiotherapy were conducted. He went on to receive temozolomide and bevacizumab. However, at 3 months after the diagnosis of lumbar metastasis, further disease progression was noted, and his care was transitioned to best supportive care. Comparison on copy number status between primary and metastatic lesions on methylation array analysis revealed more enhanced chromosomal instability including 7p loss, 7q gain and 8 gain in the metastatic lesion.ConclusionBased upon the literature review and our case, younger age of initial presentation, multiple surgical interventions, and long overall survival seem to be the risk factors of vertebral metastasis. As the prognosis of glioblastoma improves over time, its vertebral metastasis is seemingly more common. Therefore, extradural metastasis should be kept in mind in the treatment of glioblastoma. Further, detailed genomic analysis on multiple paired specimens is mandated to elucidate the molecular mechanisms of vertebral metastasis.https://www.frontiersin.org/articles/10.3389/fonc.2023.1101552/fullglioblastomavertebral metastasiscraniotomymethylation array analysiscopy number alterationchromosomal instability |
| spellingShingle | Ako Matsuhashi Shota Tanaka Hirokazu Takami Masashi Nomura Masako Ikemura Yoshitaka Matsubayashi Yusuke Shinoda Keisuke Yamada Yu Sakai Yasuaki Karasawa Shunsaku Takayanagi Nobuhito Saito Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology Frontiers in Oncology glioblastoma vertebral metastasis craniotomy methylation array analysis copy number alteration chromosomal instability |
| title | Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology |
| title_full | Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology |
| title_fullStr | Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology |
| title_full_unstemmed | Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology |
| title_short | Recurrent glioblastoma metastatic to the lumbar vertebra: A case report and literature review: Surgical oncology |
| title_sort | recurrent glioblastoma metastatic to the lumbar vertebra a case report and literature review surgical oncology |
| topic | glioblastoma vertebral metastasis craniotomy methylation array analysis copy number alteration chromosomal instability |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1101552/full |
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