Jornal de Patologia Médica e Cirúrgica
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Metastatic Glioblastoma: A Case Report and Review of the Literature

William T. Harrison, Christine M. Hulette, Cynthia Guy, Thomas Sporn, Thomas Cummings

Glioblastoma, the most common and aggressive primary glial tumor, has a median survival time of approximately 3 months without medical treatment. Surgical resection, radiotherapy, and chemotherapy are the main methods of treatment and have been shown to increase life expectancy 1 to 2 years. The tumor has an infiltrative growth pattern that distorts the normal anatomy and can extend to distant parts of the brain along white matter tracts. While glioblastoma commonly infiltrates surrounding brain tissue and intracranial metastases to the meninges and spinal cord are frequently reported, extra-cranial metastases are extremely rare. This is most probably due to the lack of lymphatic vessels in the brain and inability of the malignant cells to invade blood vessels. We present a case of a 56- year-old female with a history of right temporal glioblastoma, who was found to have biopsy proven metastases to the lung. The patient presented for a chest x-ray, as part of a requirement for a clinical trial, and was found to have bilateral lung nodules; a subsequent chest computed tomography (CT) scan showed numerous pulmonary nodules and low density lesions in the liver. The patient underwent right thoracoscopic wedge resection. Frozen section and permanent sections were diagnostic of metastatic glioblastoma.