Glioblastoma with leptomeningeal dissemination, symptomatic intramedullary extension, and bone marrow metastases

Glioblastoma (GB) is the most common primary Central Nervous System (CNS) tumor and the most malignant of the glial neoplasm; despite its aggressive behavior, metastases are rarely seen. The most common form of metastasis is leptomeningeal dissemination, which can be present in almost 15-35% of the patients, though symptomatic spinal cord invasion is far less common (1.6%), and extra neural metastases are an atypical event (0.2-3%). Here, we present the case of a 36-year-old patient with primary GB who developed leptomeningeal dissemination, intramedullary extension, and multiple extra neural metastases, including bone marrow, vertebra, skull, and liver, without primary site recurrence.