原发性弥漫性软脑膜胶质母细胞瘤：一例报告及文献综述

Primary diffuse leptomeningeal glioblastoma: a case report and literature review.

作者信息

Mondia Mark Willy L, Hooks Rebekka E, Maragkos Georgios A, Smith Vanessa L, McCord Matthew R, Donahue Joseph H, Williams Eli S, Lopes M Beatriz, Schiff David, Asthagiri Ashok R

机构信息

Division of Neuro-Oncology, Department of Neurology, University of Virginia, 1300, Jefferson Park Avenue West Complex Room 6225, Charlottesville, 22908, VA, USA.

Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.

出版信息

J Neurooncol. 2025 Mar;172(1):265-272. doi: 10.1007/s11060-024-04908-8. Epub 2024 Dec 12.

DOI:10.1007/s11060-024-04908-8

PMID:39666263

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11832630/

Abstract

PURPOSE

Glioblastoma (GBM) that presents as leptomeningeal disease (LMD) is extremely rare and fatal. Limited data are available regarding incidence, clinical presentation, and management. Prognosis is poor and no treatment is known to improve survival.

METHODS AND RESULTS

We present a case report of a 72-year-old female who presented with depressed sensorium, ataxia, and myelopathy. Magnetic resonance imaging (MRI) showed diffuse supratentorial and spinal LMD. There was an absence of any detectable and distinct intraparenchymal lesion on neuroaxis imaging. Biopsy of the Sylvian fissure nodule revealed GBM. Steroid therapy was ineffective for symptom relief. She opted for palliative care and expired shortly after diagnosis.

CONCLUSION

To our knowledge, this is the first reported case of GBM presenting exclusively as LMD without a primary lesion. If systemic imaging techniques do not provide a biopsy target and cerebrospinal fluid (CSF) studies are non-diagnostic, tissue diagnosis from leptomeningeal biopsy is recommended. Palliative chemoradiation or best supportive care are reasonable treatment options.

摘要