Table 1.
Previously reported cases of primary extracranial extension or metastasis of high-grade glioma without prior surgical or adjuvant treatment.
| Case study | Age/Sex | Lesion location | Extracranial extension | Imaging findings | Clinical features | Histopathology | Other genetic features | IDH status | MGMT status |
|---|---|---|---|---|---|---|---|---|---|
| Shuangshoti et al. (1987) (11) | 69/F | left temporoparietooccipital lobe | Galea aponeurotica, parieto-occipital skull, and dura mater | Inhomogeneous ring-enhancing mass | Headache, stupor, nausea | Glioblastoma multiforme (GFAP-positive) | NA | NA | NA |
| Shuangshoti et al. (1987) (11) | 30/M | right frontotemporal lobe | Dura mater and sphenoid bone | Midline structures shifted 2 cm to the left | Headache, bilateral blurred vision, anorexia | Glioblastoma multiforme (GFAP-positive) | NA | NA | NA |
| Shuangshoti et al. (1987) (11) | 25/F | Right subfrontal and temporal regions | Adjacent dura mater, sphenoid bone, ethmoid bone, and orbit | Destruction of the right ethmoid bone and posterior right orbit | Seizure, diplopia, right proptosis | Glioblastoma multiforme (GFAP-positive) | NA | NA | NA |
| Rainov et al. (1996) (10) | 66/F | left temporal lobe | Paranasal sinuses, orbit, temporal bone, and pterygoid muscles | Slight perifocal edema of surrounding white matter | Headache, left-sided facial pain, painful temporal swelling | Glioblastoma multiforme (strong GFAP- positive) | Functional p53 inactivation; no EGFR or MDM2 overexpression | NA | NA |
| Sade et al. (2006) (25) | 55/M | right temporal lobe | Infratemporal fossa and lateral sphenoid sinus | Right temporal mass involving the cavernous sinus and infratemporal fossa and extending into the sphenoid sinus | Progressive headache | Gliosarcoma (GFAP- and S-100-positive) | No EGFR amplification or 1p/19q loss by FISH | NA | NA |
| Thakar et al. (2015) (15) | 53/M | right temporal lobe | Right sphenoid, maxillary sinus, squamous temporal bone, and orbit | Right temporal and subtemporal lesion with invasion into the infratemporal fossa | Right-sided proptosis and right temporal swelling | Glioblastoma multiforme (GFAP-positive) | NA | NA | NA |
| Nguyen et al. (2016) (26) | 44/F | right temporal lobe | Orbit, maxillary sinus, right pterygoid, masseter, and temporalis muscles | Increased midline shift, mass effect, and vasogenic edema | Difficulty opening the right jaw, cheek and temporal swelling, severe headache with retroauricular pain radiating to the neck | Gliosarcoma (GFAP-positive) | ATRX expression retained | IDH-wildtype (IDH1 R132H-negative by IHC; no IDH1 or IDH2 mutation detected by pyrosequencing) | NA |
| Taghipour Zahir et al. (2017) (27) | 60/M | Right frontal lobe and corpus callosum | Right frontal bone with lytic areas | Dura and galea infiltrated; large areas of necrosis and hemorrhage | Seizures and egg-sized right frontal parasagittal mass | Glioblastoma multiforme (GFAP-, S-100-, CD68-, OLIG2-, and p53-positive) | NA | NA | NA |
| Stib et al. (2017) (28) | 42/F | Right frontal lobe | Anterior skull base and intranasal extension | Mass extended through the anterior skull base into the right ethmoid and maxillary sinuses and nasal cavity | Chronic sinusitis, rhinorrhea, and near-total obstruction of the right nasal passage | Anaplastic oligoastrocytoma (GFAP-, p53-, and IDH1-positive) | No deletion of either 1p or 19q by FISH | IDH1-positive by IHC | NA |
| Present case | 37/F | Right temporal lobe | Dura, temporal bone, and temporalis muscle | Hemorrhagic hypervascular temporal mass with contiguous transdural and calvarial extension | Headache and vomiting | Glioblastoma, IDH-wildtype, CNS WHO grade 4 (GFAP- and OLIG2-positive) | BRAF V600E; TERT C250 T; EGFR amplification; CDKN2A/B homozygous deletion; isolated 19q deletion | IDH1/IDH2 wild-type by NGS | Unmethylated |
F, female; M, male; GFAP, glial fibrillary acidic protein; IDH, isocitrate dehydrogenase; IHC, immunohistochemistry; FISH, fluorescence in situ hybridization; MGMT, O6-methylguanine-DNA methyltransferase; NA, not available; NGS, next-generation sequencing; OLIG2, oligodendrocyte transcription factor 2.