[Diffuse bone marrow metastasis of an anaplastic oligodendroglioma]

The authors report a case of anaplastic oligodendroglioma, in which multiple bone metastases developed about 6 years after the first craniotomy. A 32-year-old woman was admitted because of an apathetic state. CT scan and angiography suggested right frontal glioma. On August 15, 1977, a right frontal lobectomy was performed and histological sections showed anaplastic oligodendroglioma. Postoperative course was uneventful and she was discharged after chemoradiotherapy. In January, 1982, CT scan suggested recurrence of the right frontal tumor. On February 8, 1982, the second craniotomy was performed and this time, local radiation therapy by the afterloading technique (192Ir seed assembly) was given after the operation. In March, 1983, she began to complain of low back pains and multiple bone metastases were found by bone X-Ps and scintigrams. Biopsy of bone metastases was performed and at the same time, the whole body was surveyed for malignant tumors. But no primary cancer other than the right frontal brain tumor was found. In spite of therapy such as IFN, her condition gradually deteriorated and she died in December, 1983. Histological bone biopsy sections showed anaplastic oligodendroglioma much like the histology of the first operation. As the progress of curative means has increased, so has also the number of long-time survivors of malignant brain tumors. And in proportion to the increase in long-time survivors, cases of extracranial metastases may also increase. The etiology, diagnosis and therapy of extracranial metastases from the literature was also studied.