title: Atypical presentation and progression of glioblastoma multiforme in a 6-year-old girl: multidisciplinary case report.
abstract: Glioblastoma multiforme is the most common adult malignant brain tumor but is notably less common in children. The authors describe the case of a child who presented for evaluation and treatment of neurologic signs caused by a brain stem glioma. Response to radiotherapy and chemotherapy with temozolomide was initially positive, but later extensive leptomeningeal metastasis developed. Biopsy proved the lesion to be glioblastoma multiforme. During salvage irradiation to the spine and unirradiated brain, the patient complained of hip and femur pain. Subsequent radiographs demonstrated multiple bony metastases. This pattern of spread is uncharacteristic and emphasizes the importance of adequate metastatic evaluation.
authors.affiliation: Department of Radiation Medicine, University of Kentucky, College of Medicine, Lexington, Kentucky 40536-0001, USA. cdjahraus@msn.com
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Jahraus
authors.forename: Megan K
authors.initials: MK
authors.lastname: Dishop
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Bayliff
authors.forename: Charles
authors.initials: C
authors.lastname: Lee
authors.forename: William H
authors.initials: WH
authors.lastname: St  Clair
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D002648:Child; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging