Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017636 (glioblastoma)
 18,345 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Extracranial metastasis of glioblastoma is rare. This is an autopsy case report of a patient with glioblastoma multiforme found to have metastasized to the liver. A 42-year-old woman was admitted with a chief complaint of headache. Physical and neurological examinations on admission showed no abnormalities. CT and MRI demonstrated a tumor in the left parietooccipital region with invasion into the subependymal area of the left lateral ventricular trig-one. A cerebral angiogram showed tumor staining in the same area. Subtotal tumor resection was performed uneventfully. The microscopic diagnosis was glioblastoma multiforme. Postoperatively, the patient underwent whole brain and local irradiation, and intra-arterial ACNU infusion therapy. One month later, she developed low back pain, probably due to spinal dissemination. Postmortem examination showed local recurrence of the tumor and subarachnoidal dissemination not only in the base of the skull but in the lower spinal cord. Tumor was also observed in the liver, but no lung or lymph node metastasis was detected. Metastasis to the liver in this patient is believed to have occurred via the anastomosis between the vertebral and portal venous system.
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PMID:[Glioblastoma multiforme with liver metastasis--case report]. 754 23

The present paper investigates the pharmacokinetics of pirarubicin (THP) in the plasma and cerebrospinal fluid (CSF) of two patients with glioma during hyperosmotic disruption of the blood-brain barrier (HODBBB) and intra-arterial combination chemotherapy. A 42-year-old Japanese man (patient A) with glioblastoma and a 21-year-old Japanese woman (patient B) with astrocytoma received a course of HODBBB and intra-arterial combination chemotherapy with THP, methotrexate, peplomycin, and vindesine. Patient A was initially administered mannitol, followed by the infusion of anticancer drugs into the right internal carotid artery. Patient B was initially administered mannitol, followed by the infusion of anticancer drugs into the right internal carotid artery and, immediately thereafter, into the right vertebral artery. Samples of blood and of CSF in the brain ventricle were obtained. THP concentration was measured by HPLC, and the pharmacokinetic parameters of this drug were estimated in plasma and CSF. In both patients, the plasma concentration of THP peaked at the end of infusion, then decreased in a bi-exponential decay pattern during the remainder of the treatment period. THP was detectable in CSF beginning 1.0 h after the initiation of infusion, then was slowly eliminated from the ventricle. The maximum CSF concentration of THP was 0.97% of plasma in patient A and 0.89% in patient B. The CSF AUC of THP was 28.4% of plasma in patient A and 13.1% in patient B.
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PMID:Pharmacokinetics of intra-arterially administered pirarubicin in plasma and cerebrospinal fluid of patients with glioma. 955 64

Glioblastomas rarely metastasize outside the CNS. We biologically characterized a case of secondary glioblastoma associated with extracranial progression and distant metastasis. A 42-year-old male patient was subjected to craniotomy for a left temporal tumor (astrocytoma grade II) and subsequently underwent another 3 craniotomies due to tumor recurrences. At the third craniotomy, extracranial progression was noted, and the tumor was classified as a glioblastoma. In order to pinpoint the genes expressed differentially in the intracranial primary tumor and the metastatic tumors, we used cDNA microarray. The patterns of gene expression in these 2 samples were highly similar, suggesting that the mechanism of metastasis was direct infiltration of tumor cells into extracranial blood vessels. Insulin-like growth factor binding protein-2 was overexpressed in both primary and metastatic tumors. Immunohistochemical studies of DNA-dependent protein kinase, which participates in the repair of DNA, was strongly positive in the samples obtained at the first and second operations, but the positive rates were markedly reduced in the specimens obtained at the third and fourth operations. These results suggest that insulin-like growth factor binding protein-2 and deficiency of DNA-dependent protein kinase proteins promoted tumor progression in the present case.
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PMID:Biologic characterization of a secondary glioblastoma with extracranial progression and systemic metastasis. 1262 29

We report a case of glioblastoma due to putaminal hemorrhage. Notably, the glioblastoma was located at some distance from the hematoma. A 42-year-old right-handed man presented with a sudden-onset headache, motor aphasia, and right hemiplegia. CT showed left putaminal hemorrhage and a mass lesion with a slightly high density in the midbrain away from the hematoma. Conservative treatment was initiated for the patient. Initially, we suspected a benign tumor-like cavernous malformation based on the CT findings. However, MRI showed ring enhancement of the mass lesion on contrast-enhanced MRI and hyperintensity on arterial spin labeling(ASL). A part of the wall of the putaminal hemorrhage also exhibited hyperintensity on ASL. Since we suspected a malignant brainstem tumor and a secondary intracerebral hemorrhage caused by this tumor, we performed a stereotactic brain biopsy. Histological examination revealed that the tumor was a wild-type <i>IDH-1</i> glioblastoma. In the acute phase, the intracerebral hemorrhage presented as a hyperintensity on T1-weighted imaging. Therefore, it was difficult to distinguish hemorrhagic glioblastoma from an intracerebral hemorrhage. Even if an intracerebral hemorrhage is observed at common sites, it is important to consider the possibility of a malignant brain tumor and complete a prompt examination. In addition, ASL imaging may be useful in detecting hemorrhagic malignant brain tumors.
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PMID:[A Case of Putaminal Hemorrhage Caused by Underlying Tectal Glioblastoma]. 3307 Dec 28