Extraneural metastasis of high grade glioma without simultaneous central nervous system recurrence: case report

A 21-year-old man presented with extraneural metastases to the peritoneum, pleura, bone marrow, lymph nodes, and other organs from a pulvinar high grade glioma. He had undergone a shunt operation and three tumor removals during a 6-year period. He also received radiotherapy and adjuvant chemotherapy with 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride and interferon-beta. Two and a half years after the last surgery, extraneural metastasis to the peritoneal cavity was discovered. He died 13 months after the occurrence of extraneural metastases and 10 years after the initial diagnosis. Autopsy revealed tumor masses in the peritoneum, pleura, bone marrow, lymph nodes, and other organs, but no recurrent tumor of the primary lesion or metastases to other areas in the central nervous system. Systemic metastases from primary intracranial tumors are rare, but are likely to become more frequent as the prognosis of patients with brain tumors improves and the duration of survival lengthens.