Al-Sardi Mais, Alfayez Ali, Alwelaie Yazeed, Al-Twairqi Abdullah, Hamadi Faris, AlOkla Khalid
King Fahad Medical City, Riyadh, Saudi Arabia.
Case Rep Pulmonol. 2022 Jun 18;2022:5453420. doi: 10.1155/2022/5453420. eCollection 2022.
Glioblastoma is a common primary brain tumor that has a high mortality rate. Reports of intrathoracic metastases are uncommon, with the most commonly reported site for metastases are the lung and pleura. However, involvement of the mediastinum is not well documented, and few reports of confirmed mediastinal metastases diagnosed by endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) exist. Herein, we report a rare case of metastatic glioblastoma to the thorax. A lady in her 40s has been previously diagnosed with intracranial glioblastoma with multiple incidences of disease recurrence despite treatment with chemoradiotherapy, adjuvant chemotherapy, and repeated surgical resections. She presented with dyspnea and pleural effusion, for which radiological imaging revealed lung, pleural, and mediastinal lesions. Further diagnostic workup with EBUS and pleural fluid sampling confirmed metastatic disease to both sites. The pleural fluid showed highly atypical cells positive for GFAP, and EBUS-TBNA immunostains were GFAP, S100, and synaptophysin positive, giving an overall picture consistent with metastatic glioblastoma. The patient was referred for palliative care, and unfortunately, she passed away after several months.
胶质母细胞瘤是一种常见的原发性脑肿瘤，死亡率很高。胸内转移的报道并不常见，最常报道的转移部位是肺和胸膜。然而，纵隔受累的记录并不充分，通过支气管内超声引导下经支气管针吸活检（EBUS-TBNA）确诊纵隔转移的报道很少。在此，我们报告一例罕见的胶质母细胞瘤胸内转移病例。一名40多岁的女性此前被诊断为颅内胶质母细胞瘤，尽管接受了放化疗、辅助化疗和多次手术切除，但疾病仍多次复发。她出现呼吸困难和胸腔积液，影像学检查显示肺部、胸膜和纵隔病变。通过EBUS和胸腔积液采样进行的进一步诊断检查证实了这两个部位的转移性疾病。胸腔积液显示GFAP阳性的高度非典型细胞，EBUS-TBNA免疫染色GFAP、S100和突触素呈阳性，总体情况与转移性胶质母细胞瘤一致。该患者被转诊接受姑息治疗，不幸的是，几个月后她去世了。
