Increasing C-reactive protein levels in a patient with glioblastoma with lymph node metastasis. A case report

Abstract

Abstract Background: Glioblastoma multiforme is an intractable brain tumor; however, extracranial metastases are rare. The sites of metastasis vary and include the lungs, bone, lymph nodes, and liver, with approximately half of patients with extracranial metastasis having metastasis in the lymph nodes. Most patients with extracranial metastases experience recurrence of the primary intracranial tumor. Lymph node metastases are often detected based on symptoms caused by other metastatic sites or lymphadenopathy. However, this case report describes a patient with glioblastoma with lymph node metastasis, whose C-reactive protein levels gradually increased prior to becoming febrile. Case presentation: We reporta case of lymph node metastasis in glioblastoma multiforme that was difficult to diagnose because the patient had fever of unknown origin and the intracranial tumor did not recur. The patient was asymptomatic with a slowly increasing C-reactive protein levels without signs of infection, and he became febrile 9 months after the initial increase. The chest computed tomography performed supraclavicular, mediastinal, and hilarlymphadenopathy, and biopsy revealed lymph node metastasis of glioblastoma. This is the fifth case of lymph node metastasis without intracranial recurrence. Conclusions: C-reactive protein levels may be a marker for the diagnosis of lymph node metastasis in patients with glioblastoma.