Metastatic astrocytoma

Two women, treated with surgery and radiotherapy for cerebral astrocytoma, developed metastases. In one case a metastasis in a craniotomy scar was probably implanted at the time of surgery; at first this was sensitive to chemotherapy and radiotherapy, but it later recurred and became resistant to treatment, with resistant tumour spreading extensively through the scalp and the cervical lymphatic chain. In the other case tumour disseminated hematogenously to the bone marrow. Both patients died of metastatic disease with primary tumours apparently well controlled. The syndrome of metastatic astrocytoma may be under-diagnosed.