[An autopsy case of extraneural metastases of giant cell glioblastoma with intracerebral hemorrhage].

We report a case in which a 71-year-old man with a giant cell glioblastoma who had a spontaneous intracerebral hematoma including subarachnoid hemorrhage and extraneural multiple metastases followed by the craniotomy 9 months later. He had complained of nausea and vomiting on 20, October, 1981 and admitted to the Ohara hospital. For that reason, he was admitted to our hospital on 29, October, 1981 and a CT scan showed a large subcortical high dence mass accompanied by adjacent edema in the right frontal lobe. Gradually he got worse with Korsakoff's syndrome and motor weakness of the left side. Total removal of the hematoma and adjacent tissue by transcortical route on 24, November, 1981 was performed, followed by 60Co radiation therapy to the local area, chemotherapy and immunotherapy. The surgical specimen showed typical features of giant cell glioblastoma with intratumoral hemorrhage. After 9 months of the operation, he had complained of the subcutaneous tumor in the supraclavicular region and swelling of the right arm. After the second admission on 30, August, 1982, a biopsy of the tumor revealed malignant tumor cells resembling intracerebral giant cell glioblastoma. He died on 29, November, 1982. At autopsy, extraneural metastases were revealed at some lymph nodes, organs and bones. However, a primary tumor was not found in the other organs. Lymph node: cervical, supraclavicular, mediastinal, bronchial, pancreaticoduodenal, hepatic hilus, mesenteric, retroperitoneal, and parastomach. Organ: esophagus, Ileum, jejunum, adrenal gland and kidney. Bone: vertebra (thoraco-lumbar), sternum, rib. Positive reaction to GFA protein antibody was demonstrated in the tumor cells in the periphery of the surgical specimen of the brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)