The pathways of extraneural spread in metastasizing gliomas: A report of three cases and critical review of the literature

doi:10.1016/S0046-8177(79)80051-9

Human Pathology

Volume 10, Issue 4, July 1979, Pages 453-467

https://doi.org/10.1016/S0046-8177(79)80051-9 Get rights and content

Abstract

The pathways of extraneural spread in metastasizing gliomas are examined in the context of three new reported cases of glioblastoma, malignant astrocytoma, and medulloblastoma, with extraneural metastases. On the basis of a critical review of 116 cases now recorded in the literature, it is apparent that the most frequent single factor in the development of this complication is direct access of the glioma to the extrameningeal tissues as a prerequisite for more distant dissemination. Although this often follows craniotomy, it is clear that transdural access in continuity is not necessarily provided through the operative flap and that it may occur at sites removed from, or independent of, the site of operation, as demonstrated in two of the three cases described in this article. The development of extraneural metastases may be indirectly related to previous surgery or radiation therapy by virtue of the increasing length of survival from which the patient has benefited. On the other hand, there is also increasing evidence that distant metastases may occur in the absence of previous operation or radiotherapy. Although it must therefore be assumed that tumor invasion of blood vessels within the central nervous system must have occurred in these cases, the fact that intratumoral vessel permeation has seldom been substantiated microscopically in gliomas presumably accounts for the rarity of distant metastases. It is also possible that systemic immunologic factors militate against such a development and that the cytokinetics of glioma growth are such that death of the patient results from the intracranial lesion before distant deposits become detectable.

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^*: Study supported by Graduate Neuropathology Training Grant 5T01 NS5500-11 from the National Institute of Neurological and Communicative Diseases and Stroke, U. S. Public Health Service.

^†: Assistant Professor of Pathology (Neuropathology), University of Cincinnati College of Medicine, Cincinnati, Ohio.

^‡: Professor of Pathology (Neuropathology), Stanford University School of Medicine, Stanford, California.

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The pathways of extraneural spread in metastasizing gliomas: A report of three cases and critical review of the literature*

Abstract

Glial tumor metastases through a ventriculopleural shunt. Resultant massive pleural effusion

Arch. Neurol.

Extracranial metastases from medulloblastomas

Radiology

Metastasis via ventriculo-peritoneal shunt in patients with medulloblastoma

J. Neurosurg.

Medulloblastoma with extracranial metastasis through a ventriculovenous shunt

Am. J. Clin. Path.

Glioblastoma with extracranial metastasis through ventriculopleural shunt. Case report

J. Neurosurg.

Glioblastoma with extraneural metastasis by way of ventriculopleural anastomosis

Trans. Am. Neurol. Assoc.

Glioblastoma multiforme with extracranial metastases in the absence of previous craniotomy. Case report

J. Neurosurg.

Extracranial metastases from a glioma in the absence of surgical intervention

J. Neurol. Neurosurg. Psychiat.

Lymph node metastasis as first manifestation of glioblastoma. Case report

J. Neurosurg.

Primary neuroblastoma of the central nervous system with spontaneous extracranial metastases

J. Neurosurg.

Glioblastoma multiforme with extraneural metastases in the absence of previous surgery

Cancer

Spontaneous transdural extension of malignant astrocytoma. Case report

J. Neurosurg.

Ependymoblastoma grossly eroding and involving overlying dura and skull. Report of a case

J. Neurosurg.

Gliomas involving the temporal bone. Clinical and pathological aspects

Laryngoscope

Malignant ependymoma involving the temporal bone with remote metastasis

Can. J. Otolaryngol.

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J. Neurosurg.

A metastasizing ependymoma of the cauda equina

Cancer

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J. Neurosurg.

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J. Neuropath.

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Ann. Surg.

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J. Path.

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Arch. Path.

Glioblastoma and fibrosarcoma of the brain with extracranial metastases

Cancer

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J. Laryngol. Otol.

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Neurochir. (Stuttgart)

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Arch. Path.

Extracranial metastasis of glioblastoma multiforme

J. Neurosurg.

Brain tumor with extracranial metastases

Arch. Neurol.

Transdural spread of glioblastoma multiforme

J. Path. Bacteriol.

Extracranial metastases of anaplastic cerebral gliomas

Acta Neurochir.

Extracranial metastases of a glioblastoma multiforme

J. Neurosurg.

A case of glioblastoma multiforme with extracranial metastases

J. Formosan Med. Assoc.

Extracranial metastases in cerebellar medulloblastoma

J. Path. Bacteriol.

Metastatic cerebellar sarcoma (desmoplastic medulloblastoma) with diffuse osteosclerosis and leukoerythroblastic anemia. A case report and review of the literature

Am. J. Roentgen.

Generalized osteosclerosis secondary to metastatic medulloblastoma of the cerebellum

Radiology

Les métastases des tumeurs cérébrales primitives en dehors du nevraxe. À propos de trois observations

Bull. Cancer

Medulloblastoma with extracranial metastases

Arch. Neurol.

Extra-axial spread of medulloblastoma

Cancer

Cerebellar medulloblastoma with post-operative extracranial spread. Report of a case

J. Neurosurg.