A case of epidural glioblastoma metastasis presenting with a cervical myelopathy, torticollis, and L'hermitte's phenomenon

Brain Tumor Pathol. 2018 Jul;35(3):181-185. doi: 10.1007/s10014-018-0319-y. Epub 2018 May 9.

Abstract

Extraneural glioblastoma metastases are exceedingly rare, though previously described in the literature. Activating mutations in the BRAF kinase gene (V600E) are present in a minority of glioblastoma patients. Here, we describe a case of systemic metastases of a clonal subpopulation of BRAF V600E mutated glioblastoma in a patient previously treated with surgery, radiation, temozolomide and bevacizumab. The patient presented with a subacute cervical myelopathy during adjuvant treatment. He underwent emergent surgical decompression of an epidural spine metastasis. Analysis of the metastatic tumor demonstrated clonal expansion of a BRAF V600E subpopulation. Though rare, systemic metastasis of glioblastoma should be considered in patients presenting with subacute complaints in line with a mass lesion.

Keywords: BRAF V600E; Glioblastoma; L’hermitte’s phenomenon; Metastasis.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae
  • Combined Modality Therapy
  • Decompression, Surgical
  • Epidural Neoplasms / complications*
  • Epidural Neoplasms / genetics
  • Epidural Neoplasms / pathology*
  • Epidural Neoplasms / therapy
  • Fatal Outcome
  • Glioblastoma / complications*
  • Glioblastoma / genetics
  • Glioblastoma / pathology*
  • Glioblastoma / therapy
  • Humans
  • Male
  • Mutation
  • Neoplasm Metastasis*
  • Proto-Oncogene Proteins B-raf / genetics
  • Spinal Cord Diseases / etiology*
  • Torticollis / etiology*
  • Young Adult

Substances

  • Proto-Oncogene Proteins B-raf