{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:46:43Z","timestamp":1785775603873,"version":"3.56.0"},"reference-count":26,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Introduction: Glioblastoma (GBM) is an aggressive primary brain tumor that rarely metastasizes outside the central nervous system, with reported rates of extracranial dissemination below 2%. Increasing survival and improved diagnostic capabilities may contribute to more frequent detection of this phenomenon. Case Presentation: We describe a retrospective case series of 3 consecutive patients with histopathologically confirmed IDH-wild-type GBM who developed extracranial metastases at our institution. Clinical, radiological, pathological, and molecular data were extracted from medical records. Histopathological confirmation of metastatic disease was achieved in 2 of three patients, and an independent second-opinion pathology review was obtained for 1 case. Patient 1 (55-year-old man) developed cervical lymph node metastasis within 6 months of initial resection despite MGMT promoter methylation; the recurrent tumor contained a primitive neuroectodermal tumor-like component, immunophenotypically supported by diffuse Ki-67 positivity (\u223c100%) and expression of synaptophysin, chromogranin, CD56, and NSE. Patient 2 (56-year-old man) developed rapid systemic dissemination to bone, lung, liver, and the interatrial septum approximately 18 months after diagnosis; the metastatic tumor displayed mesenchymal (gliosarcoma-like) differentiation with co-expression of GFAP, SMA, and h-caldesmon, PD-L1 SP263 CPS 10\/TPS 10%, retained mismatch-repair proteins, and a clinically significant TP53 c.833C&gt;G (p.Pro278Arg) mutation identified by NGS. Patient 3 (48-year-old woman) survived 61 months despite unfavorable molecular markers, with late leptomeningeal and multiorgan dissemination. Overall survival was 8, 22, and 61 months for patients 1, 2 and 3, respectively. Conclusions: This series illustrates three distinct biological trajectories of extracranial GBM dissemination and supports the concept that prolonged survival, repeated surgical interventions, and specific molecular features (mesenchymal differentiation, PD-L1 expression, TP53 mutation) may unmask systemic metastatic potential in IDH-wild-type GBM. Clinicians should maintain a high index of suspicion for extracranial dissemination in long-term GBM survivors and in patients with atypical systemic symptoms; targeted use of whole-body 18F-FDG PET\/CT and histopathological confirmation of suspicious lesions are essential for accurate diagnosis.<\/jats:p>","DOI":"10.1159\/000553017","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:00:56Z","timestamp":1781539256000},"page":"1087-1099","source":"Crossref","is-referenced-by-count":0,"title":["Glioblastoma beyond the Brain: A Case Series Demonstrating Systemic Metastatic Potential"],"prefix":"10.1159","volume":"19","author":[{"given":"Nidal","family":"Salim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-9469","authenticated-orcid":false,"given":"Kristina","family":"Tumanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Loyko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Travin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab200"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043330"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers3010461"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-011-0575-8"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab200"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2023.108895"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.05.063"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3765"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/nature03128"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2013.09.034"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-1846"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1038\/nature14432"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dc1a69"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2015.494"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nov172"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.2008.00167.x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nou307"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2016.991"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308345"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.21586"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3171\/2010.9.SPINE091005"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2023.108895"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-020-00906-9"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1905"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-017-1300-7"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000553017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:00:58Z","timestamp":1785772858000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000553017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000553017","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32664888","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}