Extra primary seeding of glioblastoma multiforme in the subarachnoid space and ependyma

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Abstract
Four cases of glioblastoma multiforme among a series of 40 showing seeding and implants in the subarachnoid space and ventricular ependymal lining at a distance from the parent tumor are described. One case, discovered at autopsy, was not subjected to the possible provocative causes of dissemination such as surgery, X-irradiation, cytotoxic agents, or corticosteroids and thus the role of time as a factor in conjunction with disturbed local tissue immunity must be considered. The significance of the recent theories of cytopathogenesis and tissue immunity in relation to metastatic spread in the cases reported here and in the literature is discussed. Inherent implications in the case presentations and discussion are the problems of the appropriate conduct and treatment of patients with glioblastoma multiforme.

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