Malignant gliomas — Glioblastoma multiforme and astrocytoma III–IV with extracranial metastases

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Abstract
The authors describe two rare cases of extraneural metastases of glioblastoma multiforme and of astrocytoma III–IV, but with different distribution routes. In the first case—astrocytoma III–IV—via the lymphatic system, with metastases in the cervical lymph nodes; in the second case—glioblastoma—via the blood system, with metastases in the sternum and vertebrae. Survival times were 18 months in the astrocytoma case (operation plus irradiation), and 6 months in the glioblastoma case (operation, irradiation, and chemotherapy). The discussion deals with the possible paths of the metastases, the connection between metastatic spread and survival time (in the longer surviving patient the metastases were discovered together with the recurrence), and problems in deciding the individual therapy.