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|Year : 2022 | Volume
| Issue : 2 | Page : 836
Cervical Lymph Node Metastasis in Glioblastoma Multiformae
Jaskaran Singh1, Jasleen Kaur2
1 Department of Neurosurgery, Columbia Asia Hospital, Patiala, Punjab, India
2 Department of Pathology, Columbia Asia Hospital, Patiala, Punjab, India
|Date of Submission||05-Jul-2021|
|Date of Decision||28-Jul-2021|
|Date of Acceptance||08-Sep-2021|
|Date of Web Publication||3-May-2022|
Dr. Jaskaran Singh
Department of Neurosurgery, Columbia Asia Hospital, Patiala, Punjab - 147 001
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh J, Kaur J. Cervical Lymph Node Metastasis in Glioblastoma Multiformae. Neurol India 2022;70:836
Metastasis in cases of glioblastoma multiforme are extremely rare, having an incidence of 0.2%−2% in the literature., 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.,,, Most common sites of metastasis are lungs/pleura, lymph nodes, bones, and liver., 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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