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多形性胶质母细胞瘤多处颅外转移:一例病例报告及文献复习。

Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review.

机构信息

Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China.

Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China.

出版信息

J Int Med Res. 2020 Jun;48(6):300060520930459. doi: 10.1177/0300060520930459.

Abstract

Extracranial metastasis from glioblastoma multiforme (GBM) is rare, especially multi-site metastases without intracranial recurrence. However, the metastatic mechanism of GBM remains unknown and there is currently no consensus regarding the best therapeutic regimen. We report the case of a 46-year-old man with primary GBM who developed scalp metastases and subsequent multiple pulmonary metastases. He was treated with the Stupp regimen after surgery for the intracranial tumor. However, a series of soft masses in the scalp were subsequently identified, and new nodules were found in his left eyebrow arch during chemoradiotherapy. Despite salvage chemotherapy and targeted therapy, the patient eventually died of respiratory failure with multiple pulmonary metastases. This case highlights the need for rigorous follow-up, including brain magnetic resonance imaging, in patients with GBM. The occurrence of extra-central nervous system symptoms indicates the possibility of metastasis, and the relevant examinations should be conducted promptly. Positive therapies may help to relieve symptoms and prolong survival in patients with metastatic GBM.

摘要

脑外转移胶质母细胞瘤(GBM)很少见,特别是没有颅内复发的多部位转移。然而,GBM 的转移机制尚不清楚,目前对于最佳治疗方案也没有共识。我们报告了一例 46 岁的原发性 GBM 患者,他在颅内肿瘤手术后出现头皮转移,随后出现多个肺部转移。他在手术后接受了 Stupp 方案治疗。然而,在放化疗过程中,他的头皮上又出现了一系列软组织肿块,并且在他的左眉弓处发现了新的结节。尽管进行了挽救性化疗和靶向治疗,患者最终还是因呼吸衰竭和多发性肺转移而死亡。该病例强调了对 GBM 患者进行严格随访的必要性,包括脑磁共振成像。出现中枢神经系统以外的症状提示转移的可能性,应及时进行相关检查。对于转移性 GBM 患者,积极的治疗可能有助于缓解症状和延长生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf25/7303784/3179506c572d/10.1177_0300060520930459-fig1.jpg

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