Diffuse vertebral body metastasis from a glioblastoma multiforme: a technetium-99m Sestamibi single-photon emission computerized tomography study - Case report

The authors report on a case of right temporal glioblastoma multiforme (GBM ) that metastasized to multiple bone regions (dorsolumbar vertebrae and ili ac bone) 8 months after initial diagnosis, despite combined radio- and chem otherapy. Results of a whole-bone single-photon emission computerized tomog raphy (SPECT) study using the imaging agent Sestamibi (MIBI) revealed extra cranial metastases from the GEM. A magnetic resonance imaging study of the dorsolumbar spinal region completed the radiological investigation. Cells i mmunoreactive to glial fibrillary acidic protein were observed in a specime n obtained from the right iliac bone. Postmortem examination confirmed meta stasis to extracranial bone and revealed two other metastatic localizations in the lung and heart. This is the first reported case of extracranial bon e metastasis from a GEM demonstrated on a whole-bone MIBI SPECT scan. In pa tients with malignant glioma and lower-back pain (especially prolonged pain ), bone metastasis, although uncommon, does occasionally occur and its poss ibility should be investigated; a MIBI SPECT study may prove useful in this regard.