Glioblastoma multiforme with gliosarcoma with metastasis to lung

A 51 year old female presented with headache and projectile vomiting of 1 month duration, and her systemic examination was non-contributory. Blood and urine investigations were normal. MRI brain identified a mass lesion in the right frontal lobe and anterior body of corpus callosum with areas of peri-lesional edema. Craniotomy was performed with right frontal lobectomy and tumour excised. Biopsy confirmed Glioblastoma multiforme with gliosarcomatous areas. Adjuvant external beam irradiation with concurrent temozolamide was administered followed by adjuvant temozolamide. Subject developed breathlessness 8 months after surgery, and PET scan performed revealed mildly enhancing metabolically active area in genu of corpus callosum and metabolically active left sided pleural based masses with left pleural effusion. Biopsy from the pleural based lesion was consistent with metastatic disease from Glioblastoma Multiforme. Extra-cranial metastasis in a case of glioblastoma multiforme is uncommon.