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Extracranial Metastases From Glioblastoma With Primitive Neuronal Components on FDG PET/CT.
Matthew D Kay1, Holly E Pariury2, Arie Perry3
1From the Departments of Medical Imaging.
Clinical Nuclear Medicine
|December 27, 2019
Summary
This case highlights how Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) can detect widespread extracranial metastases in pediatric glioblastoma, especially those with primitive neuronal components.
Area of Science:
- Neuro-oncology
- Pediatric oncology
- Medical imaging
Background:
- Glioblastoma (WHO grade IV) is rare in children.
- Primitive neuronal components and specific mutations (histone H3 G34-mutant, IDH1 wild type) are associated with aggressive disease.
- Extracranial metastases are more frequent in pediatric glioblastoma with primitive neuronal components.
Observation:
- A 17-year-old patient presented with glioblastoma (WHO grade IV) and suspected vertebral metastases.
- Whole-body Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) was used for staging.
- Initial MRI had shown vertebral metastases.
Findings:
- FDG PET/CT revealed extensive extracranial disease.
- Findings included spinal leptomeningeal dissemination, osseous metastases, and peritoneal seeding.
- Metastases were noted through a ventriculoperitoneal shunt.
Implications:
- FDG PET/CT is a valuable tool for staging pediatric glioblastoma with primitive neuronal components.
- This imaging modality can identify distant metastases not apparent on conventional MRI.
- Early detection of extracranial spread can inform treatment strategies for this rare and aggressive cancer.
