Glioblastoma multiforme metastatic to lung in the absence of intracranial recurrence: case report.

We present the case of a 65 year old gentleman who underwent craniotomy and debulking of a left temporal glioblastoma multiforme (GBM). Post-operatively he received chemotherapy and radiotherapy with good response demonstrated on interval MRI scans. At 17 months post-diagnosis and in the absence of clinical or radiological recurrence, he presented with respiratory distress. He was found to have an exudative right-sided pleural effusion, nodular pleural thickening, a hilar mass and associated lymphadenopathy. Percutaneous pleural biopsy revealed metastatic GBM. Systemic GBM metastasis despite good response to oncological treatments and in the absence of intracranial recurrence is exceedingly rare. We review the literature concerning extra-neuraxial GBM metastasis and speculate why this phenomenon is extremely rare.