Multiple extracranial metastases from secondary glioblastoma multiforme: a case report and review of the literature.

Extracranial metastasis of glioblastoma multiforme (GBM) is very rare, in spite of very aggressive tumor behavior and being documented in only a few patients. In this article we present a 25-year-old man with secondary glioblastoma associated with extracranial progression and distant metastasis. He was diagnosed by magnetic resononce (MR) with an intracranial lesion in the right parietofrontal region, which was subsequently resected. Histology revealed a diffuse astrocytoma (grade II). The tumor recurred 1 year later and the patient received a second craniotomy. A diagnosis of GBM was made. After radiotherapy, he presented with right cervical lymph node metastases. The cytomorphological features supported a diagnosis of metastatic glioblastoma multiforme. The neck dissection was made and histology confirmed the fine needle aspiration diagnosis of glioblastoma multiforme. MR with diffusion-weighted imaging revealed right cervical lymph node metastases and multi-bone metastases (mainly pelvic bone) 3 weeks later.