{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T20:32:00Z","timestamp":1774470720105,"version":"3.50.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"20","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,13]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Glioblastoma (GBM) is the most common primary brain tumor with poor patient prognosis. Spinal leptomeningeal metastasis has been rarely reported, with long intervals between the initial discovery of the primary tumor in the brain and eventual spine metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>Here, the authors present the case of a 51-year-old male presenting with 7 days of severe headache, nausea, and vomiting. Magnetic resonance imaging of the brain and spine demonstrated a contrast-enhancing mass in the pineal region, along with spinal metastases to T8, T12, and L5. Initial frozen-section diagnosis led to the treatment strategy for medulloblastoma, but further molecular analysis revealed characteristics of isocitrate dehydrogenase\u2013wild type, grade 4 GBM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Glioblastoma has the potential to show metastatic spread at the time of diagnosis. Spinal imaging should be considered in patients with clinical suspicion of leptomeningeal spread. Furthermore, molecular analysis should be confirmed following pathological diagnosis to fine-tune treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23536","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T18:54:05Z","timestamp":1699901645000},"source":"Crossref","is-referenced-by-count":3,"title":["Spinal metastases of pineal region glioblastoma with primitive neuroectodermal features highlighting the importance of molecular diagnoses: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Aaryan","family":"Shah","sequence":"first","affiliation":[{"name":"Neurosurgery Artificial Intelligence Lab, Stanford University School of Medicine, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelan J","family":"Marianayagam","sequence":"additional","affiliation":[{"name":"Neurosurgery Artificial Intelligence Lab, Stanford University School of Medicine, Stanford, California"},{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aroosa","family":"Zamarud","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit R","family":"Persad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott G","family":"Soltys","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Veeravagu","sequence":"additional","affiliation":[{"name":"Neurosurgery Artificial Intelligence Lab, Stanford University School of Medicine, Stanford, California"},{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neuro Oncol","first-page":"ii","article-title":"CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006\u20132010","volume":"15","author":"Ostrom QT","year":"2013","unstructured":"Ostrom QT, Gittleman H, Farah P,  CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006\u20132010. Neuro Oncol. 2013;15(2 Suppl):ii, 1\u201356."},{"issue":"6","key":"b2","series-title":"Neurotherapeutics","first-page":"1705","article-title":"Updates in IDH-wildtype glioblastoma","volume":"19","author":"Melhem JM","year":"2022","unstructured":"Melhem JM, Detsky J, Lim-Fat MJ, Perry JR. Updates in IDH-wildtype glioblastoma. Neurotherapeutics. 2022;19(6):1705\u20131723."},{"issue":"9","key":"b3","series-title":"J Natl Cancer Inst","first-page":"704","article-title":"Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials","volume":"85","author":"Curran WJ Jr","year":"1993","unstructured":"Curran WJ Jr, Scott CB, Horton J,  Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst. 1993;85(9):704\u2013710."},{"issue":"8","key":"b4","series-title":"J Clin Oncol","first-page":"1275","article-title":"Recurrence pattern after temozolomide concomitant with and adjuvant to radiotherapy in newly diagnosed patients with glioblastoma: correlation with MGMT promoter methylation status","volume":"27","author":"Brandes AA","year":"2009","unstructured":"Brandes AA, Tosoni A, Franceschi E,  Recurrence pattern after temozolomide concomitant with and adjuvant to radiotherapy in newly diagnosed patients with glioblastoma: correlation with MGMT promoter methylation status. J Clin Oncol. 2009;27(8):1275\u20131279."},{"issue":"3","key":"b5","series-title":"Clin Radiol","first-page":"355","article-title":"CSF seeding of intra-cranial tumours: a study of 96 cases","volume":"25","author":"Bryan P","year":"1974","unstructured":"Bryan P. CSF seeding of intra-cranial tumours: a study of 96 cases. Clin Radiol. 1974;25(3):355\u2013360."},{"issue":"5","key":"b6","series-title":"Clin Neurol Neurosurg","first-page":"407","article-title":"Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis","volume":"113","author":"Witoonpanich P","year":"2011","unstructured":"Witoonpanich P, Bamrungrak K, Jinawath A, Wongwaisayawan S, Phudhichareonrat S, Witoonpanich R. Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis. Clin Neurol Neurosurg. 2011;113(5):407\u2013410."},{"issue":"2","key":"b7","series-title":"Turk Neurosurg","first-page":"242","article-title":"Accuracy of frozen-section diagnosis of brain tumors: an 11-year experience from a tertiary care center","volume":"29","author":"Obeidat FN","year":"2019","unstructured":"Obeidat FN, Awad HA, Mansour AT, Hajeer MH, Al-Jalabi MA, Abudalu LE. Accuracy of frozen-section diagnosis of brain tumors: an 11-year experience from a tertiary care center. Turk Neurosurg. 2019;29(2):242\u2013246."},{"issue":"6","key":"b8","series-title":"Ann Diagn Pathol","first-page":"359","article-title":"Frozen section discrepancy in the evaluation of nonneoplastic central nervous system samples","volume":"13","author":"Plesec TP","year":"2009","unstructured":"Plesec TP, Prayson RA. Frozen section discrepancy in the evaluation of nonneoplastic central nervous system samples. Ann Diagn Pathol. 2009;13(6):359\u2013366."},{"issue":"4","key":"b9","series-title":"Acta Cytol","first-page":"667","article-title":"High diagnostic accuracy of cytologic smears of central nervous system tumors. A 15-year experience based on 4,172 patients","volume":"46","author":"Roessler K","year":"2002","unstructured":"Roessler K, Dietrich W, Kitz K. High diagnostic accuracy of cytologic smears of central nervous system tumors. A 15-year experience based on 4,172 patients. Acta Cytol. 2002;46(4):667\u2013674."},{"issue":"2","key":"b10","series-title":"Ann Clin Lab Sci","first-page":"133","article-title":"Utility of intra-operative consultations for the diagnosis of central nervous system lesions","volume":"31","author":"Savargaonkar P","year":"2001","unstructured":"Savargaonkar P, Farmer PM. Utility of intra-operative consultations for the diagnosis of central nervous system lesions. Ann Clin Lab Sci. 2001;31(2):133\u2013139."},{"issue":"4","key":"b11","series-title":"Neurosurgery","first-page":"516","article-title":"Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series","volume":"27","author":"Vertosick FT Jr","year":"1990","unstructured":"Vertosick FT Jr, Selker RG. Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery. 1990;27(4):516\u2013522."},{"issue":"3","key":"b12","series-title":"J Neurooncol","first-page":"227","article-title":"Symptomatic spinal dissemination of malignant astrocytoma","volume":"61","author":"Saito R","year":"2003","unstructured":"Saito R, Kumabe T, Jokura H, Shirane R, Yoshimoto T. Symptomatic spinal dissemination of malignant astrocytoma. J Neurooncol. 2003;61(3):227\u2013235."},{"key":"b1","series-title":"Neuro Oncol","first-page":"ii","article-title":"CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006\u20132010","volume":"15","author":"Ostrom QT","year":"2013","unstructured":"Ostrom QT, Gittleman H, Farah P,  CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006\u20132010. Neuro Oncol. 2013;15(2 Suppl):ii, 1\u201356."},{"issue":"6","key":"b2","series-title":"Neurotherapeutics","first-page":"1705","article-title":"Updates in IDH-wildtype glioblastoma","volume":"19","author":"Melhem JM","year":"2022","unstructured":"Melhem JM, Detsky J, Lim-Fat MJ, Perry JR. Updates in IDH-wildtype glioblastoma. Neurotherapeutics. 2022;19(6):1705\u20131723."},{"issue":"9","key":"b3","series-title":"J Natl Cancer Inst","first-page":"704","article-title":"Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials","volume":"85","author":"Curran WJ Jr","year":"1993","unstructured":"Curran WJ Jr, Scott CB, Horton J,  Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst. 1993;85(9):704\u2013710."},{"issue":"8","key":"b4","series-title":"J Clin Oncol","first-page":"1275","article-title":"Recurrence pattern after temozolomide concomitant with and adjuvant to radiotherapy in newly diagnosed patients with glioblastoma: correlation with MGMT promoter methylation status","volume":"27","author":"Brandes AA","year":"2009","unstructured":"Brandes AA, Tosoni A, Franceschi E,  Recurrence pattern after temozolomide concomitant with and adjuvant to radiotherapy in newly diagnosed patients with glioblastoma: correlation with MGMT promoter methylation status. J Clin Oncol. 2009;27(8):1275\u20131279."},{"issue":"3","key":"b5","series-title":"Clin Radiol","first-page":"355","article-title":"CSF seeding of intra-cranial tumours: a study of 96 cases","volume":"25","author":"Bryan P","year":"1974","unstructured":"Bryan P. CSF seeding of intra-cranial tumours: a study of 96 cases. Clin Radiol. 1974;25(3):355\u2013360."},{"issue":"5","key":"b6","series-title":"Clin Neurol Neurosurg","first-page":"407","article-title":"Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis","volume":"113","author":"Witoonpanich P","year":"2011","unstructured":"Witoonpanich P, Bamrungrak K, Jinawath A, Wongwaisayawan S, Phudhichareonrat S, Witoonpanich R. Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis. Clin Neurol Neurosurg. 2011;113(5):407\u2013410."},{"issue":"2","key":"b7","series-title":"Turk Neurosurg","first-page":"242","article-title":"Accuracy of frozen-section diagnosis of brain tumors: an 11-year experience from a tertiary care center","volume":"29","author":"Obeidat FN","year":"2019","unstructured":"Obeidat FN, Awad HA, Mansour AT, Hajeer MH, Al-Jalabi MA, Abudalu LE. Accuracy of frozen-section diagnosis of brain tumors: an 11-year experience from a tertiary care center. Turk Neurosurg. 2019;29(2):242\u2013246."},{"issue":"6","key":"b8","series-title":"Ann Diagn Pathol","first-page":"359","article-title":"Frozen section discrepancy in the evaluation of nonneoplastic central nervous system samples","volume":"13","author":"Plesec TP","year":"2009","unstructured":"Plesec TP, Prayson RA. Frozen section discrepancy in the evaluation of nonneoplastic central nervous system samples. Ann Diagn Pathol. 2009;13(6):359\u2013366."},{"issue":"4","key":"b9","series-title":"Acta Cytol","first-page":"667","article-title":"High diagnostic accuracy of cytologic smears of central nervous system tumors. A 15-year experience based on 4,172 patients","volume":"46","author":"Roessler K","year":"2002","unstructured":"Roessler K, Dietrich W, Kitz K. High diagnostic accuracy of cytologic smears of central nervous system tumors. A 15-year experience based on 4,172 patients. Acta Cytol. 2002;46(4):667\u2013674."},{"issue":"2","key":"b10","series-title":"Ann Clin Lab Sci","first-page":"133","article-title":"Utility of intra-operative consultations for the diagnosis of central nervous system lesions","volume":"31","author":"Savargaonkar P","year":"2001","unstructured":"Savargaonkar P, Farmer PM. Utility of intra-operative consultations for the diagnosis of central nervous system lesions. Ann Clin Lab Sci. 2001;31(2):133\u2013139."},{"issue":"4","key":"b11","series-title":"Neurosurgery","first-page":"516","article-title":"Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series","volume":"27","author":"Vertosick FT Jr","year":"1990","unstructured":"Vertosick FT Jr, Selker RG. Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery. 1990;27(4):516\u2013522."},{"issue":"3","key":"b12","series-title":"J Neurooncol","first-page":"227","article-title":"Symptomatic spinal dissemination of malignant astrocytoma","volume":"61","author":"Saito R","year":"2003","unstructured":"Saito R, Kumabe T, Jokura H, Shirane R, Yoshimoto T. Symptomatic spinal dissemination of malignant astrocytoma. J Neurooncol. 2003;61(3):227\u2013235."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/20\/article-CASE23536.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/20\/article-CASE23536.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/20\/article-CASE23536.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:34:34Z","timestamp":1770302074000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/20\/article-CASE23536.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,13]]},"references-count":24,"journal-issue":{"issue":"20"},"URL":"https:\/\/doi.org\/10.3171\/case23536","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,13]]}}}