Extracranial metastasis of anaplastic oligoastrocytoma

Abstract

Extracranial metastasis (ECM) of glioma is a rare condition that occurs in the internal nervous axis. A 23-year-old woman presented with anaplastic oligoastrocytoma (WHO III) in a left temporal tumor. The patient received chemoradiotherapy after surgery in our center. Three years after treatment, the patient experienced multiple ECMs in the right lung, left iliac bone, and multiple swollen subcutaneous nodules including the right clavicle, back of the neck, left forearm, right upper arm, and right clavicle. The patient died of cerebral herniation at the age of 27 due to recurrent intracranial glioma. Treatment of ECM of glioma remains very challenging, and further investigations are needed.

Keywords: Extracranial metastasis (ECM); anaplastic oligoastrocytoma; chemoradiotherapy; glioma.

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(A) Preoperative brain MRI revealed the left temporal lesions. (B-D) Pathological result showed anaplastic oligoastrocytoma (WHO III). (B) H&E staining (100 x). (C) GFAP (200 x). (D) Oligo-2 (200 x). (E and F) Chest CT scanning revealed the right lung lesions, right hilar and mediastinal lymph node metastasis. (G) The biopsy of the right supraclavicular lymph nodes. (H-J) Pathologic findings showed fibrous connective tissue can be seen in tumor cell infiltration, considering anaplastic oligodendrocyte metastasis. (H) H&E staining (100 x). (I) GFAP (200x). (J) Oligo-2 (200 x). (K) Repeated MRI revealed a lesion in the left occipital lobe, which suggested intracranial glioma recurrence.