Vertebral metastasis of a cerebellar glioblastoma multiforme - a case report

We report a very rare case of a 70 years old patient with a cerebellar glioblastoma (GBM) who presented with a worsening of paraparesis 6 months after craniotomy and total macroscopic tumor removal. A magnetic resonance imaging (MRI) study revealed a diffuse lesion in the vertebral bodies of the thoracic level Th9 to Th11. The patient was diagnosed with metastatic tumor or malignant tumor, therefore, he underwent emergent local radiation. The patient’s condition improved. Later a full body positron emission tomography (PET) scan was realized and revealed another lesion in Th3. A glioblastoma multiforme was diagnosed by biopsy. This case is rare by many aspects : the advanced age of the patient, the rapid time between the craniotomy and the discovery of the metastasis, the metastasis of an infratentiorial cerebellar glioblastoma, the metastasis after a macroscopic total resection without recurrence in the brain. To our knowledge this is the first case reported of an extraneural bone metastasis from a GBM demonstrated on a whole body PET study. In patient with malignant glioma and worsening of paraparesis, bone metastasis, although uncommon, does occasionally occur and its possibility should be investigated. A PET study may prove to be useful in this regard.

Author(s):

Sandra Vuignier, Takeshi Aoyama, Kazutoshi Hida, Kiyohiro Houkin

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