Shuto T, Fujino H, Inomori S, Nakayama S, Satoh H, Ideguchi H, Tashiro Y
Department of Neurosurgery, Yokohama Rosai Hospital, Japan.
No To Shinkei. 1995 Aug;47(8):772-7.
Extracranial metastasis of glioblastoma is rare. This is an autopsy case report of a patient with glioblastoma multiforme found to have metastasized to the liver. A 42-year-old woman was admitted with a chief complaint of headache. Physical and neurological examinations on admission showed no abnormalities. CT and MRI demonstrated a tumor in the left parietooccipital region with invasion into the subependymal area of the left lateral ventricular trig-one. A cerebral angiogram showed tumor staining in the same area. Subtotal tumor resection was performed uneventfully. The microscopic diagnosis was glioblastoma multiforme. Postoperatively, the patient underwent whole brain and local irradiation, and intra-arterial ACNU infusion therapy. One month later, she developed low back pain, probably due to spinal dissemination. Postmortem examination showed local recurrence of the tumor and subarachnoidal dissemination not only in the base of the skull but in the lower spinal cord. Tumor was also observed in the liver, but no lung or lymph node metastasis was detected. Metastasis to the liver in this patient is believed to have occurred via the anastomosis between the vertebral and portal venous system.
胶质母细胞瘤的颅外转移罕见。本文报告一例多形性胶质母细胞瘤尸检病例,该病例被发现已转移至肝脏。一名42岁女性因头痛为主诉入院。入院时体格检查和神经系统检查均未发现异常。CT和MRI显示左侧顶枕叶区域有一肿瘤,侵犯左侧侧脑室三角区的室管膜下区域。脑血管造影显示同一区域有肿瘤染色。顺利进行了肿瘤次全切除。显微镜诊断为多形性胶质母细胞瘤。术后,患者接受了全脑和局部放疗以及动脉内阿糖胞苷(ACNU)灌注治疗。一个月后,她出现腰痛,可能是由于脊髓播散所致。尸检显示肿瘤局部复发,蛛网膜下腔播散不仅见于颅底,也见于脊髓下段。肝脏中也观察到肿瘤,但未检测到肺或淋巴结转移。该患者肝脏转移被认为是通过椎静脉系统和门静脉系统之间的吻合发生的。