Achi Jimmy, Achi Xavier Wong, Veintimilla Paula, Cueva Janina
Department of Neurosurgery, Hospital Clínica Kennedy, Guayaquil, Ecuador.
Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico.
Surg Neurol Int. 2023 Jun 23;14:218. doi: 10.25259/SNI_191_2023. eCollection 2023.
Glioblastoma (GB) is the most common and aggressive malignant brain tumor in adults. Extracranial metastases are very rare, been described in the lungs, soft tissue, or the intraspinal space.
Through a PubMed-based bibliographic search, the authors reviewed the cases reported in the literature to date, emphasizing the epidemiology and pathophysiology of this rare condition. A clinical case of a 46-year-old man with an initial diagnosis of gliosarcoma, who received complete surgical and adjuvant treatment and later recurred as GB with incidental finding of a lung tumor, whose pathology reported metastasis of the primary, is illustrated.
Understanding the pathophysiology, it is likely that the incidence of extraneural metastases may continue to increase. Considering improvements in diagnostic techniques that allow early diagnosis, as well as advances in neurosurgical therapy and multimodal management with the aim of improving patient survival, the period in which malignant cells can spread and form extracranial metastases could increase. When screening should be performed to detect metastases in these patients is still not clear. The neuro-oncologists should pay attention to the systematic survey for extraneural metastasis of the GB. Timely detection and early treatment improve overall quality of patients' life.
胶质母细胞瘤（GB）是成人中最常见且侵袭性最强的恶性脑肿瘤。颅外转移非常罕见，曾在肺部、软组织或椎管内被描述过。
通过基于PubMed的文献检索，作者回顾了迄今为止文献中报道的病例，重点关注这种罕见病症的流行病学和病理生理学。文中展示了一例临床病例，一名46岁男性最初被诊断为胶质肉瘤，接受了完整的手术及辅助治疗，后来复发为胶质母细胞瘤，并偶然发现肺部肿瘤，其病理报告显示为原发肿瘤转移。
了解病理生理学后，神经外转移的发生率可能会持续上升。鉴于诊断技术的进步使得早期诊断成为可能，以及神经外科治疗和多模式管理的进展旨在提高患者生存率，恶性细胞能够扩散并形成颅外转移的时间段可能会增加。对于这些患者应何时进行筛查以检测转移尚不清楚。神经肿瘤学家应关注胶质母细胞瘤颅外转移的系统检查。及时检测和早期治疗可提高患者的整体生活质量。
