title: Intractable vomiting from glioblastoma metastatic to the fourth ventricle: three case studies.
abstract: Dissemination of malignant glioma to the fourth ventricle with metastatic deposits and intractable vomiting is rare. Leptomeningeal extension of malignant glioma is an uncommon condition that has been reported in patients with end-stage disease and is usually unresponsive to any treatment modality. We describe 3 patients with progressing recurrent glioblastoma multiforme in whom leptomeningeal invasion manifested itself as intractable vomiting due to tumor metastases in the floor of the fourth ventricle. All patients received additional radiation therapy focused to the posterior fossa, with complete resolution of vomiting occurring within 10 days after irradiation. The remission of symptoms in these patients persisted until their death 3-4 months after the repeat radiation therapy. These reports indicate that additional focused radiation should be considered because of its significant therapeutic effect in alleviating intractable nausea and vomiting in patients with glioma metastasized to the posterior fossa.
authors.affiliation: Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Zvi R
authors.initials: ZR
authors.lastname: Cohen
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Hassenbusch
authors.forename: Moshe H
authors.initials: MH
authors.lastname: Maor
authors.forename: Raphael M
authors.initials: RM
authors.lastname: Pfeffer
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy; D002551:Cerebral Ventricle Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy; D020546:Fourth Ventricle; D005909:Glioblastoma / Q000150:complications / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010296:Parietal Lobe; D013702:Temporal Lobe; D014839:Vomiting / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents