Extracranial spreading of glioblastoma multiforme.

On the basis of 4 observations, the formation of extracranial metastases of multiform glioblastomas is dealth with which complied with all the criteria established by Weiss (histological identification of a primary brain tumour, connection of clinical data between cerebral tumour and metastases, ruling out of another primary tumour not belonging to the neuraxis by a complete autopsy). All 4 patients were--in some cases several times--trephined, subjected to postoperative irradiation and some of them were also treated with chemotherapeutics. The postoperative survival time was between 16 and 24 months, the average age of the patients was 35 years which was strikingly low. 3 patients showed infiltrations of bones and neighbouring soft parts, in one case the tumour penetrated into the sinus, in one patient paranasal sinuses and orbitae were affected, two cases showed metastases in the vertebral column and in one case metastases were found in the cervical gland nodes. One glioblastoma accompanied by a fibrosarcoma showed a particularly extensive extracranial formation of metastases. As regards the reasons for the formation of extracranial metastases of intracranial tumors many hypotheses have been established which are critically discussed by the authors.