Lack of evidence of osteo-medullary metastases at diagnosis in patients with high grade gliomas

High grade gliomas usually show a transient response to standard therapy by radiation. A local evolution leads to patient death in most of the cases. Necropsic series suggest that metastatic evolution is rather frequent in lu ngs, lymph nodes, bones or bone marrow. Are these metastatic deposits prese nt initially? The authors retrospectively reviewed the bone marrow smears p erformed in 20 patients and the bone scans in 10 patients with high grade g liomas at time of diagnosis. None of these investigations showed metastatic deposits. It is thus suggested that metastatic deposits are probably a lat e event in the natural history of high grade gliomas. However, if local tre atment could reach local control, metastases would probably become a major problem. Thus definitive cure of high grade glioma may require multidiscipl inary approach.