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Peer-reviewedCC BY-NCCNS oncology

Early extracranial dissemination with prolonged survival in IDH-wildtype glioblastoma: case study and comprehensive literature review.

  • Colin Burns1,2
  • Cheng Chia Wu2
  • Kei Suzuki3
  • Grace Lee2
  • Daniel Kim2
  1. 1Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
  2. 2Advanced Radiation Oncology and Proton Therapy, INOVA Health System, Fairfax, VA, USA.
  3. 3Department of Surgery, Thoracic Surgery, INOVA Fairfax Medical Center, Fairfax, VA, USA.
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Abstract

Background

Extracranial metastasis of glioblastoma (GBM) is rare (0.4-2%) and associated with poor prognosis. For this report, "early extracranial dissemination" is defined as radiographically and histologically confirmed metastatic disease identified at or within one month of the index GBM diagnosis, distinguishing it from metastasis arising later in the disease course.Case presentation

A 65-year-old woman with IDH-wildtype, MGMT-methylated GBM presented with seizures, right hemiplegia, and expressive aphasia. She underwent near-total resection followed by chemoradiotherapy with temozolomide. A suspicious right lower lobe pulmonary lesion was identified on initial staging, and biopsy-confirmed GBM involving mediastinal lymph nodes was established within one month of diagnosis. Despite pulmonary and mediastinal involvement, intracranial hemorrhage, seizures, and venous thromboembolism, she survived 25 months from diagnosis and 24 months following confirmation of metastatic disease.Discussion

This case is notable for exceptionally early extracranial dissemination, pulmonary and mediastinal involvement, and prolonged post-metastatic survival. MGMT methylation and sustained temozolomide therapy may have contributed to disease control, although these observations remain hypothesis-generating.Conclusion

Early extracranial dissemination may be underrecognized and warrants further investigation through risk-stratified approaches to extracranial surveillance.

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Cite

BibTeXRIS
BibTeX
@article{burns2026early,
  title = {{Early extracranial dissemination with prolonged survival in IDH-wildtype glioblastoma: case study and comprehensive literature review.}},
  author = {Colin Burns and Cheng Chia Wu and Kei Suzuki and Grace Lee and Daniel Kim},
  journal = {CNS oncology},
  year = {2026},
  month = oct,
  doi = {10.1080/20450907.2026.2735242},
  url = {https://europepmc.org/article/MED/42872786},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Early extracranial dissemination with prolonged survival in IDH-wildtype glioblastoma: case study and comprehensive literature review.
AU  - Colin Burns
AU  - Cheng Chia Wu
AU  - Kei Suzuki
AU  - Grace Lee
AU  - Daniel Kim
PY  - 2026
DA  - 2026/10/14
JO  - CNS oncology
DO  - 10.1080/20450907.2026.2735242
UR  - https://europepmc.org/article/MED/42872786
AB  - Background  Extracranial metastasis of glioblastoma (GBM) is rare (0.4-2%) and associated with poor prognosis. For this report, "early extracranial dissemination" is defined as radiographically and histologically confirmed metastatic disease identified at or within one month of the index GBM diagnosis, distinguishing it from metastasis arising later in the disease course.Case presentation  A 65-year-old woman with IDH-wildtype, MGMT-methylated GBM presented with seizures, right hemiplegia, and expressive aphasia. She underwent near-total resection followed by chemoradiotherapy with temozolomide. A suspicious right lower lobe pulmonary lesion was identified on initial staging, and biopsy-confirmed GBM involving mediastinal lymph nodes was established within one month of diagnosis. Despite pulmonary and mediastinal involvement, intracranial hemorrhage, seizures, and venous thromboembolism, she survived 25 months from diagnosis and 24 months following confirmation of metastatic disease.Discussion  This case is notable for exceptionally early extracranial dissemination, pulmonary and mediastinal involvement, and prolonged post-metastatic survival. MGMT methylation and sustained temozolomide therapy may have contributed to disease control, although these observations remain hypothesis-generating.Conclusion  Early extracranial dissemination may be underrecognized and warrants further investigation through risk-stratified approaches to extracranial surveillance.
SN  - 2045-0907
SN  - 2045-0915
ER  -