Frank Susane, Kuhn Susane A, Brodhun Michael, Mueller Ulrike, Romeike Bernd, Kosmehl Hartwig, Regenbrecht Christian Ra, Ewald Christian, Reichart Rupert, Kalff Rolf
Department of Neurosurgery, Friedrich-Schiller-University, Erlanger Allee 101, 07747 Jena, Germany.
Neurol Neurochir Pol. 2009 Mar-Apr;43(2):183-90.
Generally, gliomas do not metastasize. Therefore, larger series are not available to investigate the pathways of tumour spread. Here, we present the case of a young man with a glioblastoma multiforme WHO grade IV and distant metastases in several tissues. The glioblastoma multiforme WHO grade IV of a young male patient recurred within a very short time along the surgical resection pathway within the temporalis muscle. After removal of the tumour bulk, the patient developed a distant intracranial tumour lesion around the contralateral ventricular system and a pulmonary tumour. Later on, the patient underwent an operation on a facial lesion representing a local extracranial glioblastoma recurrence and containing metastases within lymph nodes and lymphatic vessels. Our case report indicated a lymphatic pathway of metastasis, which could be demonstrated by our histopathological analysis. We suggest that altered gene expression stimulated by glioblastoma-environment interaction altered the properties of glioblastoma cells, whether caused by a spontaneous genetic shift or induced by factors provided by the extracranial tissue.
一般来说，胶质瘤不会发生转移。因此，没有大量病例可供研究肿瘤扩散的途径。在此，我们报告一例患有世界卫生组织IV级多形性胶质母细胞瘤且在多个组织发生远处转移的年轻男性病例。一名年轻男性患者的世界卫生组织IV级多形性胶质母细胞瘤在颞肌内沿手术切除路径在很短时间内复发。在切除大部分肿瘤后，患者在对侧脑室系统周围出现远处颅内肿瘤病变以及肺部肿瘤。后来，患者接受了面部病变手术，该病变代表颅外局部胶质母细胞瘤复发，且在淋巴结和淋巴管内含有转移灶。我们的病例报告表明存在转移的淋巴途径，这可通过我们的组织病理学分析得到证实。我们认为，胶质母细胞瘤与环境相互作用所刺激的基因表达改变，改变了胶质母细胞瘤细胞的特性，无论是由自发的基因转变还是由颅外组织提供的因素所诱导。
