| Li Wang,Rongqing Li,Xudong Feng,Shuling Song,Yong Zhang. Extramedullary skeletal muscle metastasis of glioblastoma: A case report and literature review. Oncol Transl Med, 2016, 2: 189-193. |
| Extramedullary skeletal muscle metastasis of glioblastoma: A case report and literature review |
| Received:April 27, 2016 Revised:July 21, 2016 |
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| KeyWord:glioblastoma; metastasis; histopathology |
| Author Name | Affiliation | E-mail | | Li Wang | Department of Pathology, Kunming General Hospital, Kunming 650032, China | 2001wl@163.com | | Rongqing Li | Department of Radiation Oncology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China | lrqmxl@126.com | | Xudong Feng | Department of Radiation Oncology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China | fxd23@sina.com | | Shuling Song | Department of Pathology, Kunming General Hospital, Kunming 650032, China | 871819779@qq.com | | Yong Zhang | Department of Radiation Oncology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China | newkaryon@163.com |
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| Abstract: |
| Objective: The aim of the study was to explore the clinicopathologic, immunophenotypic, and diagnostic
features of extramedullary metastases of glioblastoma.
Methods: One case of extramedullary skeletal muscle metastasis of glioblastoma was studied, including
the clinical, histological, and immunohistochemical features.
Results: A 24-year-old man underwent surgical resection for glioblastoma (WHO grade IV) in the
left temporal parietal region followed by radiotherapy and temozolomide therapy. One year and nine
months later, he developed an extramedullary skeletal muscle metastasis in L4, and the histology
was remarkably different from that of the primary glioblastoma specimen. The immunohistochemical
analysis also showed changes. In the metastasis, the small cells were negative for GFAP; weakly
positive for S-100; and positive for nestin, NSE, and CD56, with 60% of cells positive for p53 and 40%
positive for Ki-67. The giant cells showed strong positivity for GFAP and S-100, and weak expression
of p53, Ki-67, nestin, NSE, and CD56. The primary glioblastoma specimen showed strong positivity
for GFAP and S-100 and was negative for NSE, nestin, and CD56, with around 25% of the tumor cells
positive for p53 and a Ki-67 labeling index of 20%.
Conclusion: Extraneural metastasis (ENM) is a rare complication of glial tumors and glioma stem
cells may be related to the metastasis. Since extraneural metastasis may occur in patients without
central nervous symptoms, any unusual signs during the follow-up of patients diagnosed with glioblastoma
should not be underestimated. |
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