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Neuro-Oncology 2002 4(2):129-133; doi:10.1093/neuonc/4.2.129
© 2002 by Society
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© 2002 by the Society forNeuro-Oncology

Intractable vomiting from glioblastoma metastatic to the fourthventricle: Three case studies

Zvi R. Cohen1, Samuel J. Hassenbusch, Moshe H. Maor, Raphael M. Pfeffer and Zvi Ram

Departments of Neurosurgery (Z.R.C., S.J.H.) and Radiation Oncology (M.H.M.), The University of Texas M. D.Anderson Cancer Center, Houston, TX 77030; and the Department of Neurosurgery (Z.R.) and Institute of Oncology (R.M.P.), The Chaim Sheba MedicalCenter, Tel-Hashomer, Israel

1 Address correspondence and reprint requests to Zvi R. Cohen, Department ofNeurosurgery, The University of Texas M.D. Anderson Cancer Center, 1515Holcombe Blvd., Box 442, Houston, TX 77030.


  Abstract

Dissemination of malignant glioma to the fourth ventricle with metastaticdeposits and intractable vomiting is rare. Leptomeningeal extension ofmalignant glioma is an uncommon condition that has been reported in patientswith end-stage disease and is usually unresponsive to any treatment modality.We describe 3 patients with progressing recurrent glioblastoma multiforme inwhom leptomeningeal invasion manifested itself as intractable vomiting due totumor metastases in the floor of the fourth ventricle. All patients receivedadditional radiation therapy focused to the posterior fossa, with completeresolution of vomiting occurring within 10 days after irradiation. Theremission of symptoms in these patients persisted until their death 3-4 monthsafter the repeat radiation therapy. These reports indicate that additionalfocused radiation should be considered because of its significant therapeuticeffect in alleviating intractable nausea and vomiting in patients with gliomametastasized to the posterior fossa.

Received September 14, 2001; Accepted November 14, 2001


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