Breaking boundaries: A rare case of glioblastoma with uncommon extraneural metastases: A case report and literature review

Abstract

Introduction Extraneural metastases (ENM) from glioblastoma (GBM) remain extremely rare with only a scarce number of cases described in the literature. The lack of cases leads to no consensus on the optimal treatment and follow-up of these patients. Research question Do patient or tumor characteristics describe risk factors for ENM in GBM patients, and is it possible to identify mechanisms of action? Material and methods This study presents a 55-year-old man with diagnosed GBM who was referred to a CT due to reduced general condition and mild back pain which revealed extensive systemic metastases. A literature review was conducted to identify potential patient or tumor characteristics that may serve as risk factors for metastasis. Results ENM from GBM are likely underreported, with limited examples in the literature and low survival rates of only a few months. Certain clinical and histopathological factors, such as male sex, younger age, temporal lobe location, and specific biological markers, have been associated with a higher likelihood of metastasis formation. Bone and/or bone marrow metastases are the most common sites. Despite various treatment regimens being attempted, there is no consensus on the optimal therapeutic approach for this patient group. Conclusion Clinical and histopathological factors can aid clinicians in recognizing the potential for ENM in GBM patients. Our review identifies some of the possible patient- and tumor-related risk factors. However, further research is crucial to identify specific molecular markers and elucidate the underlying biological mechanisms that is essential for development of targeted therapies.