{"id":"c57ffec3-8195-4c5c-b2a1-c5643738e10f","slug":"letter-to-the-editor-regarding-unusual-extraneural-metastasis-of-glioblastoma","title":"Letter to the editor regarding “unusual extraneural metastasis of glioblastoma”","authors":["Andrew Leland Waack","Aastha Dhananjay Bhavsar","Meghana R. Ranabothu","Alastair T. Hoyt","Jason L. Schroeder"],"abstract":"Background: The authors express their appreciation for Achi et al.'s case report on glioblastoma (GBM) lung metastasis while noting that the discussion on GBM metastasis mechanisms was limited. Historically, GBM has been viewed as incapable of extracranial metastasis, yet literature indicates that such occurrences are documented, with a small percentage of GBM cases exhibiting extracranial spread. Summary: The letter elaborates on various pathways of GBM metastasis, particularly highlighting iatrogenic spread and the glymphatic system. Iatrogenic spread is noted as a primary mechanism for extracranial metastasis, often occurring post-surgery. The glymphatic system is proposed as a potential pathway for metastasis, with evidence suggesting that GBM may utilize this drainage system to reach cervical lymph nodes. Conclusion: The authors commend Achi et al. for their case report and aim to enhance the discussion regarding GBM metastasis mechanisms. They emphasize the importance of minimizing iatrogenic tumor spread during surgical interventions and suggest that ongoing research into the glymphatic system could have significant implications for neuro-oncology. Keywords: glioblastoma, metastasis, iatrogenic, glymphatic, surgery, cervical lymph nodes, extracranial","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuro-oncology.png","publishDate":"2023-08-25T00:00:00.000Z","doi":"10.25259/SNI_580_2023","categories":["Neuro-oncology","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2023/08/12511/SNI-14-302.pdf"}