title: Metastatic glioblastoma cells use common pathways via blood and lymphatic vessels.
abstract: Generally, gliomas do not metastasize. Therefore, larger series are not available to investigate the pathways of tumour spread. Here, we present the case of a young man with a glioblastoma multiforme WHO grade IV and distant metastases in several tissues. The glioblastoma multiforme WHO grade IV of a young male patient recurred within a very short time along the surgical resection pathway within the temporalis muscle. After removal of the tumour bulk, the patient developed a distant intracranial tumour lesion around the contralateral ventricular system and a pulmonary tumour. Later on, the patient underwent an operation on a facial lesion representing a local extracranial glioblastoma recurrence and containing metastases within lymph nodes and lymphatic vessels. Our case report indicated a lymphatic pathway of metastasis, which could be demonstrated by our histopathological analysis. We suggest that altered gene expression stimulated by glioblastoma-environment interaction altered the properties of glioblastoma cells, whether caused by a spontaneous genetic shift or induced by factors provided by the extracranial tissue.
authors.affiliation: Department of Neurosurgery, Friedrich-Schiller-University, Erlanger Allee 101, 07747 Jena, Germany.
authors.forename: Susane
authors.initials: S
authors.lastname: Frank
authors.forename: Susane A
authors.initials: SA
authors.lastname: Kuhn
authors.forename: Michael
authors.initials: M
authors.lastname: Brodhun
authors.forename: Ulrike
authors.initials: U
authors.lastname: Mueller
authors.forename: Bernd
authors.initials: B
authors.lastname: Romeike
authors.forename: Hartwig
authors.initials: H
authors.lastname: Kosmehl
authors.forename: Christian Ra
authors.initials: CR
authors.lastname: Regenbrecht
authors.forename: Christian
authors.initials: C
authors.lastname: Ewald
authors.forename: Rupert
authors.initials: R
authors.lastname: Reichart
authors.forename: Rolf
authors.initials: R
authors.lastname: Kalff
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D005909:Glioblastoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary*; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008339:Mandibular Neoplasms / Q000473:pathology / Q000556:secondary; D008406:Masseter Muscle / Q000473:pathology