title: Meningeal seeding from glioblastoma multiforme treated with radiotherapy and temozolomide.
abstract: Extracranial and meningeal seeding of glioblastoma multiforme is rare. We report herein a case of glioblastoma in a 41-year-old man who underwent surgical resection, concomitant chemoradiotherapy (CCRT) and seven courses of adjuvant chemotherapy with temozolomide. The patient then complained of intermittent severe lower back pain and gait disturbance. Imaging studies demonstrated that although the intracranial residual tumors were well-controlled by the treatment, meningeal seeding involving the brainstem and spinal cord was present. The patient died 2 months after the diagnosis of spinal seeding. This case illustrates the need for consideration of extracranial metastasis if a patient is symptomatic, even if the intracranial tumor appears responsive to treatment. We suggested that the prophylactic craniospinal irradiation may be considered in patients at high risk of meningeal seeding immediately after surgery.
authors: Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan. Electronic address: Y01951@ms1.ylh.gov.tw.
authors: Lu-Ting
authors: LT
authors: Kuo
authors: Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Shao-Yu
authors: SY
authors: Tsai
authors: Department of Radiology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
authors: Chung-Yi
authors: CY
authors: Yang
authors: Department of Pathology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
authors: Long-Wei
authors: LW
authors: Lin
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D005909:Glioblastoma / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000556:secondary*; D009366:Neoplasm Seeding; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: glioblastoma multiforme; meningeal seeding; spinal; temozolomide