BACKGROUND Glioblastoma has a high degree of malignancy and poor prognosis.It is common to have in situ recurrence and intracranial metastasis,while extracranial metastasis is rare,and extracranial multiorgan metastas...BACKGROUND Glioblastoma has a high degree of malignancy and poor prognosis.It is common to have in situ recurrence and intracranial metastasis,while extracranial metastasis is rare,and extracranial multiorgan metastasis is extremely rare.We report a case of glioblastoma with extracranial multiorgan metastasis,which will strengthen clinicians’attention to the extracranial metastasis of glioblastoma and its treatment.CASE SUMMARY A male patient visited our hospital for treatment of dizziness and headache.Magnetic resonance imaging of the brain revealed a space-occupying lesion in the right temporoparietal occipital region.Chest computed tomography and abdominal ultrasound were normal,and no space-occupying lesions were observed in other organs of the body.The patient underwent surgery and diagnosed with glioblastoma.Postoperative concurrent radiotherapy and chemotherapy were completed.During the follow-up,the tumor was found to have metastasized to the scalp and neck,and a second tumor resection was performed.Postoperative follow-up revealed extracranial metastases to multiple extracranial organs including skull,scalp,ribs,spine,liver and lung.His family members refused further treatment,and requested only symptomatic treatment such as pain relief,and the patient died of systemic multiple organ failure.Survival time from diagnosis to death was 13 mo and from extracranial metastasis to death was 6 mo.CONCLUSION Glioblastoma extracranial metastasis is extremely rare,clinicians should always pay attention to its existence.The mechanism of glioblastoma extracranial metastasis is still unclear,and genetic and molecular studies are required.展开更多
Pancreatic ductal adenocarcinoma(PDAC)continues to have a dismal prognosis,with a 5-year survival rate of<5%.Most(70%-80%)patients are classified as unresectable(UR)disease.Recent progress in chemotherapeutic appro...Pancreatic ductal adenocarcinoma(PDAC)continues to have a dismal prognosis,with a 5-year survival rate of<5%.Most(70%-80%)patients are classified as unresectable(UR)disease.Recent progress in chemotherapeutic approaches has provided a high response rate and improved short-term survival.Recently,conversion surgery(CS),which is defined as an additional surgery during multimodal therapy in patients with initially UR-PDAC who respond favorably to anti-cancer treatments,has been successfully introduced as a novel treatment option for locally advanced(UR-LA)and metastatic(UR-M)PDAC.Several studies have demonstrated high resectability rates(UR-LA,20%-57%;UR-M,2%-24%),high margin-negative resection rates(27%-91%),and high negative lymph node rates(29%-83%)in patients who underwent CS.Most studies also demonstrated acceptable mortality and morbidity.Median survival time(MST)varied between 24.9 and 35.3 months for patients with UR-LA,19.5 and 64 months for UR-LA/M,and 26 and 56 months for UR-M,which is better than the MST of patients who did not undergo CS.The presence of M disease did not affect survival in patients who underwent CS.However,the actual clinical benefits of resection have not yet been fully investigated.There are still several issues to be resolved in this area.Therefore,sustained efforts to conduct appropriately designed clinical trials for confirming the efficacy of CS in the subset of patients with initially UR-PDAC are warranted.展开更多
基金Supported by Medical Research Fund for Young Scholars of the Sichuan Medical Association,No.Q16076Natural Science Foundation of Southwest Medical University,No.2016XNYD217and Science and Technology Projects of Sichuan Province,No.2018JY0403.
文摘BACKGROUND Glioblastoma has a high degree of malignancy and poor prognosis.It is common to have in situ recurrence and intracranial metastasis,while extracranial metastasis is rare,and extracranial multiorgan metastasis is extremely rare.We report a case of glioblastoma with extracranial multiorgan metastasis,which will strengthen clinicians’attention to the extracranial metastasis of glioblastoma and its treatment.CASE SUMMARY A male patient visited our hospital for treatment of dizziness and headache.Magnetic resonance imaging of the brain revealed a space-occupying lesion in the right temporoparietal occipital region.Chest computed tomography and abdominal ultrasound were normal,and no space-occupying lesions were observed in other organs of the body.The patient underwent surgery and diagnosed with glioblastoma.Postoperative concurrent radiotherapy and chemotherapy were completed.During the follow-up,the tumor was found to have metastasized to the scalp and neck,and a second tumor resection was performed.Postoperative follow-up revealed extracranial metastases to multiple extracranial organs including skull,scalp,ribs,spine,liver and lung.His family members refused further treatment,and requested only symptomatic treatment such as pain relief,and the patient died of systemic multiple organ failure.Survival time from diagnosis to death was 13 mo and from extracranial metastasis to death was 6 mo.CONCLUSION Glioblastoma extracranial metastasis is extremely rare,clinicians should always pay attention to its existence.The mechanism of glioblastoma extracranial metastasis is still unclear,and genetic and molecular studies are required.
文摘Pancreatic ductal adenocarcinoma(PDAC)continues to have a dismal prognosis,with a 5-year survival rate of<5%.Most(70%-80%)patients are classified as unresectable(UR)disease.Recent progress in chemotherapeutic approaches has provided a high response rate and improved short-term survival.Recently,conversion surgery(CS),which is defined as an additional surgery during multimodal therapy in patients with initially UR-PDAC who respond favorably to anti-cancer treatments,has been successfully introduced as a novel treatment option for locally advanced(UR-LA)and metastatic(UR-M)PDAC.Several studies have demonstrated high resectability rates(UR-LA,20%-57%;UR-M,2%-24%),high margin-negative resection rates(27%-91%),and high negative lymph node rates(29%-83%)in patients who underwent CS.Most studies also demonstrated acceptable mortality and morbidity.Median survival time(MST)varied between 24.9 and 35.3 months for patients with UR-LA,19.5 and 64 months for UR-LA/M,and 26 and 56 months for UR-M,which is better than the MST of patients who did not undergo CS.The presence of M disease did not affect survival in patients who underwent CS.However,the actual clinical benefits of resection have not yet been fully investigated.There are still several issues to be resolved in this area.Therefore,sustained efforts to conduct appropriately designed clinical trials for confirming the efficacy of CS in the subset of patients with initially UR-PDAC are warranted.
