Extraneural Glioblastoma Metastasis: A Case Report

Glioblastomas comprise the most common and the most malignant of primary brain tumors with a dismal prognosis. While local failure is very common even after definitive multimodality management, extracranial distant metastasis is extremely infrequent due to the absence of lymphatic drainage. In this case report, we present a 44-year-old male patient presenting with an intracranial lesion who was diagnosed to have World Health Organization (WHO) grade II oligodendroglioma following subtotal excision. Conventionally fractionated radiotherapy at a dose of 54 Gy was delivered to the local cranium after surgery. After 3 years of follow-up without progression, he was diagnosed with recurrent disease and the histopathological assessment revealed a WHO grade IV glioblastoma with malignant transformation. He had bone metastasis together with an involved neck node by direct extension. Symptomatic relief was achieved after salvage chemoirradiation. The patient is still alive after 4 years from the first diagnosis. Extracranial neck node metastasis together with bone metastasis of glioblastoma may be seen though very rarely reported in the literature. Substantial improvement in symptoms may be achieved with multimodality management in the setting of the very rare occurrence of extraneural glioblastoma metastasis.