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Table of Contents    
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 836

Cervical Lymph Node Metastasis in Glioblastoma Multiformae

1 Department of Neurosurgery, Columbia Asia Hospital, Patiala, Punjab, India
2 Department of Pathology, Columbia Asia Hospital, Patiala, Punjab, India

Date of Submission05-Jul-2021
Date of Decision28-Jul-2021
Date of Acceptance08-Sep-2021
Date of Web Publication3-May-2022

Correspondence Address:
Dr. Jaskaran Singh
Department of Neurosurgery, Columbia Asia Hospital, Patiala, Punjab - 147 001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.344663

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How to cite this article:
Singh J, Kaur J. Cervical Lymph Node Metastasis in Glioblastoma Multiformae. Neurol India 2022;70:836

How to cite this URL:
Singh J, Kaur J. Cervical Lymph Node Metastasis in Glioblastoma Multiformae. Neurol India [serial online] 2022 [cited 2023 Nov 29];70:836. Available from:

Metastasis in cases of glioblastoma multiforme are extremely rare, having an incidence of 0.2%−2% in the literature.[1],[2] These are generally seen post-surgery or when there is a breach of the blood − brain barrier due to local extradural spread. The possible mechanism of metastasis suggested are lymphatic spread, venous invasion, and direct invasion through dura and bone.[1],[2],[3],[4] Most common sites of metastasis are lungs/pleura, lymph nodes, bones, and liver.[1],[2] Here we present a case of a 45-year-old female patient who was operated for recurrent left temporal glioma (first biopsy was low-grade glioma WHO grade 2, operated 1.5 years back). The histopathology was consistent with GBM (WHO grade 4). Immunohistochemistry revealed GFAP positive, IDH-1 mutant with 40% Ki-67 index. After the second surgery, she received chemo-radiotherapy but developed a neck swelling six months after the second surgery (while on tocilizumab). MRI [Figure 1] showed a T1 hypointense, T2 hyperintense neck tumor with heterogeneous contrast enhancement.
Figure 1: (a) Sagittal section of contrast MRI with blue arrow pointing to the primary resection site having peripheral enhancement (? Recurrent lesion), red arrow showing a separate mass in the posterior triangle of neck having heterogeneous contrast enhancement. (b) FNAC of neck mass which revealed highly pleomorphic malignant cells with high nuclear: Cytoplasmic ratio in a background of fibrillary processes and lymphocytes (40× magnification, H&E stain) consistent with lymph node metastasis of glioblastoma multiforme

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Full and detailed consent from the patient/guardian has been taken. The patient's identity has been adequately anonymized. If anything related to the patient's identity is shown, adequate consent has been taken from the patient/relative/guardian. The journal will not be responsible for any medico-legal issues arising out of issues related to the patient's identity or any other issues arising from the public display of the video.

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Conflicts of interest

There are no conflicts of interest.

 » References Top

Seo YJ, Cho WH, Kang DW, Cha SH. Extraneural metastasis of glioblastoma multiforme presenting as an unusual neck mass. J Korean Neurosurg Soc 2012;51:147-50.  Back to cited text no. 1
Kalokhe G, Grimm SA, Chandler JP, Helenowski I, Rademaker A, Raizer JJ. Metastatic glioblastoma: Case presentations and a review of the literature. J Neurooncol 2012;107:21-7.  Back to cited text no. 2
Zhen L, Yufeng C, Zhenyu S, Lei X. Multiple extracranial metastases from secondary glioblastoma multiforme: A case report and review of the literature. J Neurooncol 2010;97:451-7.  Back to cited text no. 3
Amitendu S, Mak SK, Ling JM, Ng WH. A single institution experience of the incidence of extracranial metastasis in glioma. J Clin Neurosci 2012;19:1511-5.  Back to cited text no. 4


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