Cerebellar Glioblastoma with Intrathecal Dissemination:A Report of Four Cases Mariko ISHIKAWA 1 , Kazutaka SUMITA 1,2 , Kaoru TAMURA 1 , Daisuke KOBAYASHI 3 , Yusuke TSUKAHARA 1 , Motoki INAJI 1 , Yoji TANAKA 1 , Tadashi NARIAI 1 , Taketoshi MAEHARA 1 1Department of Neurosurgery, Tokyo Medical and Dental University 2Department of Endovascular Surgery, Tokyo Medical and Dental University 3Department of Human Pathology, Tokyo Medical and Dental University Keyword: glioblastoma , cerebellum , intrathecal dissemination , craniospinal irradiation pp.237-244
Published Date 2020/3/10
DOI https://doi.org/10.11477/mf.1436204169
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 Primary cerebellar glioblastoma is a rare disease that accounts for 0.4-3.4% of glioblastoma multiforme(GBM)cases. The clinicopathological characteristics and prognosis of primary cerebellar GBM are not well understood due to its rarity and the lack of an established treatment strategy. To elucidate the prognostic factors and dissemination pattern, we retrospectively assessed four cases of cerebellar GBM that we treated between 2003 and 2013. All cases involved men, and the age range was 53 to 76 years(median 69.5 years);each patient underwent surgical removal and received adjuvant chemotherapy or radiotherapy. Every cerebellar GBM patient developed intrathecal dissemination at every stage of cerebellar GBM. Two patients had spinal metastases with tumor recurrence, and no patient had brain stem invasion. IDH1 mutation and MGMT expression were both negative in three cases. The median overall survival of cerebellar GBM patients was 13.8 years, and the median progression-free survival was 5.5 years, which is similar to that reported in previous reports-and similar in terms of results-for supratentorial GBM treated at the same time at our institution.

 In conclusion, the prognosis of cerebellar GBM appears to be similar to that of supratentorial GBM;however, the pattern of tumor progression, such as intrathecal dissemination, is different. Craniospinal irradiation on cerebellar GBM should be carefully considered with frequent follow-up by whole spine survey using MRI.

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