PONTINE GLIOMA WITH OSTEOBLASTIC SKELETAL METASTASES IN A CHILD

BACKGROUND The development of systemic metastases from primary intracr anial gliomas is rare. We report here a rare case of pontine glioma wi th osteoblastic skeletal metastases. CASE This 12-year-old boy present ed with a 4-month history of hoarseness, dysphagia, and a progressivel y ataxic gait. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) revealed a brain stem tumor that was diagnosed as a low grade glioma by stereotactic biopsy. Twelve months later following ch emotherapy and radiotherapy, neurologic examination and neuroradiologi c studies disclosed a recurrence of the pontine glioma. Skeletal roent genograms revealed widespread osteoblastic metastases in the skull, ve rtebral bodies, pelvis, and long bones. A specimen from the iliac bone demonstrated cells that were immunoreactive glial fibrillary acidic p rotein (GFAP). DISCUSSION The mechanism of how glioma cells determine their biologic behavior at bony metastatic sites is not known. Infrate ntorial gliomas, which occur frequently in young patients and demonstr ate active bony metabolism, may stimulate osteoblastic cells, and indu ce osteoblastic changes. (C) 1996 by Elsevier Science Inc.