Goodwin C Rory, Liang Lydia, Abu-Bonsrah Nancy, Hdeib Alia, Elder Benjamin D, Kosztowski Thomas, Bettegowda Chetan, Laterra John, Burger Peter, Sciubba Daniel M
Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World Neurosurg. 2016 May;89:578-582.e3. doi: 10.1016/j.wneu.2015.11.061. Epub 2015 Dec 15.
Glioblastoma multiforme (GBM) is the most common malignant central nervous system tumor; however, extraneural metastasis is uncommon. Of those that metastasize extraneurally, metastases to the vertebral bodies represent a significant proportion. We present a review of 28 cases from the published literature of GBM metastasis to the vertebra. The mean age at presentation was 38.4 years with an average overall survival of 26 months. Patients were either asymptomatic with metastasis discovered at autopsy or presented with varying degrees of pain, weakness of the extremities, or other neurologic deficits. Of the cases that included the time to spinal metastasis, the average time was 26.4 months with a reported survival of 10 months after diagnosis of vertebral metastasis. A significant number of patients had no treatments for their spinal metastasis, although the intracranial lesions were treated extensively with surgery and/or adjuvant therapy. With increasing incremental gains in the survival of patients with GBM, clinicians will encounter patients with extracranial metastasis. As such, this review presents timely information concerning the presentation and outcomes of patients with vertebral metastasis.
多形性胶质母细胞瘤(GBM)是最常见的恶性中枢神经系统肿瘤;然而,神经外转移并不常见。在发生神经外转移的病例中,椎体转移占相当大的比例。我们对已发表文献中28例GBM转移至椎体的病例进行了综述。发病时的平均年龄为38.4岁,平均总生存期为26个月。患者要么在尸检时发现有转移但无症状,要么表现出不同程度的疼痛、肢体无力或其他神经功能缺损。在包含脊柱转移时间的病例中,平均时间为26.4个月,据报道椎体转移诊断后生存期为10个月。相当多的患者未对其脊柱转移进行治疗,尽管颅内病变接受了广泛的手术和/或辅助治疗。随着GBM患者生存期的逐步增加,临床医生将遇到有颅外转移的患者。因此,本综述提供了有关椎体转移患者的表现和结局的及时信息。