Journal of Korean Neurosurgical Society

  • 제58권5호
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  • Pages.479-482
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Glioblastoma Multiforme in the Pineal Region with Leptomeningeal Dissemination and Lumbar Metastasis

  • 투고 : 2014.01.15
  • 심사 : 2014.09.16
  • 발행 : 2015.11.28
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초록

We report a case of a 31-year-old woman with glioblastoma multiforme (GBM) in the pineal region with associated leptomeningeal dissemination and lumbar metastasis. The patient presented with severe headache and vomiting. Magnetic resonance imaging (MRI) of the brain showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. After an urgent ventricular-peritoneal shunt, she was treated by subtotal resection and chemotherapy concomitant with radiotherapy. Two months after surgery, MRI showed no changes in the residual tumor but leptomeningeal dissemination surrounding the brainstem. One month later, she exhibited severe lumbago and bilateral leg pain. Thoracico-lumbar MRI showed drop like metastasis in the lumbar region. Finally she died five months after the initial diagnosis. Neurosurgeons should pay attention to GBM in the pineal region, not only as an important differential diagnosis among the pineal tumors, but due to the aggressive features of leptomeningeal dissemination and spinal metastasis.

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참고문헌

  1. Amini A, Schmidt RH, Salzman KL, Chin SS, Couldwell WT : Glioblastoma multiforme of the pineal region. J Neurooncol 79 : 307-314, 2006 https://doi.org/10.1007/s11060-006-9145-x
  2. Birbilis TA, Matis GK, Eleftheriadis SG, Theodoropoulou EN, Sivridis E : Spinal metastasis of glioblastoma multiforme : an uncommon suspect? Spine (Phila Pa 1976) 35 : E264-E269, 2010 https://doi.org/10.1097/BRS.0b013e3181c11748
  3. Bradfield JS, Perez CA : Pineal tumors and ectopic pinealomas. Analysis of treatment and failures. Radiology 103 : 399-406, 1972 https://doi.org/10.1148/103.2.399
  4. Cho BK, Wang KC, Nam DH, Kim DG, Jung HW, Kim HJ, et al. : Pineal tumors : experience with 48 cases over 10 years. Childs Nerv Syst 14 : 53-58, 1998 https://doi.org/10.1007/s003810050175
  5. Edwards MS, Hudgins RJ, Wilson CB, Levin VA, Wara WM : Pineal region tumors in children. J Neurosurg 68 : 689-697, 1988 https://doi.org/10.3171/jns.1988.68.5.0689
  6. Elliott JP, Keles GE, Waite M, Temkin N, Berger MS : Ventricular entry during resection of malignant gliomas : effect on intracranial cerebrospinal fluid tumor dissemination. J Neurosurg 80 : 834-839, 1994 https://doi.org/10.3171/jns.1994.80.5.0834
  7. Frank F, Gaist G, Piazza G, Ricci RF, Sturiale C, Galassi E : Stereotaxic biopsy and radioactive implantation for interstitial therapy of tumors of the pineal region. Surg Neurol 23 : 275-280, 1985 https://doi.org/10.1016/0090-3019(85)90095-3
  8. Gasparetto EL, Warszawiak D, Adam GP, Bleggi-Torres LF, de Carvalho Neto A : Glioblastoma multiforme of the pineal region : case report. Arq Neuropsiquiatr 61 : 468-472, 2003 https://doi.org/10.1590/S0004-282X2003000300027
  9. Han SR, Yee GT, Lee DJ, Whang CJ : Spinal metastases from supratentorial glioblastoma. J Korean Neurosurg Soc 38 : 475-477, 2005
  10. Kalyanaraman UP : Primary glioblastoma of the pineal gland. Arch Neurol 36 : 717-718, 1979 https://doi.org/10.1001/archneur.1979.00500470087020
  11. Moon KS, Jung S, Jung TY, Kim IY, Lee MC, Lee KH : Primary glioblastoma in the pineal region : a case report and review of the literature. J Med Case Rep 2 : 288, 2008 https://doi.org/10.1186/1752-1947-2-288
  12. Norbut AM, Mendelow H : Primary glioblastoma multiforme of the pineal region with leptomeningeal metastases : a case report. Cancer 47 : 592-596, 1981 https://doi.org/10.1002/1097-0142(19810201)47:3<592::AID-CNCR2820470328>3.0.CO;2-G
  13. Ozgural O, Kahilogullari G, Bozkurt M, Heper AO, Savas A : Primary pineal glioblastoma : a case report. Turk Neurosurg 23 : 572-574, 2013
  14. Pople IK, Arango JC, Scaravilli F : Intrinsic malignant glioma of the pineal gland. Childs Nerv Syst 9 : 422-424, 1993 https://doi.org/10.1007/BF00306198
  15. Ringertz N, Nordenstam H, Flyger G : Tumors of the pineal region. J Neuropathol Exp Neurol 13 : 540-561, 1954 https://doi.org/10.1097/00005072-195410000-00004
  16. Stark AM, Nabavi A, Mehdorn HM, Blomer U : Glioblastoma multiforme-report of 267 cases treated at a single institution. Surg Neurol 63 : 162-169; discussion 169, 2005 https://doi.org/10.1016/j.surneu.2004.01.028
  17. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. : Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352 : 987-996, 2005 https://doi.org/10.1056/NEJMoa043330
  18. Toyooka T, Miyazawa T, Fukui S, Otani N, Nawashiro H, Shima K : Central neurogenic hyperventilation in a conscious man with CSF dissemination from a pineal glioblastoma. J Clin Neurosci 12 : 834-837, 2005 https://doi.org/10.1016/j.jocn.2004.09.027
  19. Vaquero J, Ramiro J, Martinez R : Glioblastoma multiforme of the pineal region. J Neurosurg Sci 34 : 149-150, 1990
  20. Vertosick FT Jr, Selker RG : Brain stem and spinal metastases of supratentorial glioblastoma multiforme : a clinical series. Neurosurgery 27 : 516-521; discussion 521-522, 1990 https://doi.org/10.1227/00006123-199010000-00002
  21. Zada G, Bond AE, Wang YP, Giannotta SL, Deapen D : Incidence trends in the anatomic location of primary malignant brain tumors in the United States : 1992-2006. World Neurosurg 77 : 518-524, 2012 https://doi.org/10.1016/j.wneu.2011.05.051

피인용 문헌

  1. Glioblastoma of pineal region: report of four cases and literature review vol.6, pp.4, 2015, https://doi.org/10.2217/cns-2016-0047
  2. Stereotactic radiosurgery versus whole-brain radiotherapy after intracranial metastasis resection: a systematic review and meta-analysis vol.12, pp.None, 2015, https://doi.org/10.1186/s13014-017-0840-x
  3. Pineal region glioblastomas display features of diffuse midline and non-midline gliomas vol.140, pp.1, 2015, https://doi.org/10.1007/s11060-018-2931-4
  4. Diagnosis, treatment, and survival in spinal dissemination of primary intracranial glioblastoma: systematic literature review vol.31, pp.5, 2015, https://doi.org/10.3171/2019.5.spine19164
  5. Pineal Region Glioblastomas: Clinical Characteristics, Treatment, and Survival Outcome vol.146, pp.None, 2015, https://doi.org/10.1016/j.wneu.2020.11.016