Extracranial metastases (EM) in brain tumors are extremely rare. Oligodendroglioma is the least common brain tumor type to metastasize. Reported extracranial sites are bone, bone marrow, lymph nodes, liver, lung and scalp. Risk factors are prior neurosurgical resection and a prolonged survival of low grade glioma patients. No standard treatment exists, but temozolomide is the preferred treatment option. This work is a single case observation of a patient with oligodendroglioma and multiple EM. Histology was confirmed by an independent reference center. In 1997 a now 49-year-old male patient was diagnosed with oligoastrocytoma WHO II sinistral frontoparietal. In 2004 and 2009 local recurrence was detected. He received total resection and adjuvant chemotherapy (PCV). Histology showed an oligodendroglioma with anaplastic parts and a partial loss of 1p19q. 2012 again local recurrence was detected in MRI and the patient underwent gamma knife treatment. In August 2016 a calvaria lesion occurred, the histology revealed bone metastasis of oligodendroglioma. A PET-CT ten months later showed multiple thoracic and femoral bone metastases, while the lungs were tumor free. No specific treatment was obtained.In November 2017, the patient was admitted due to lymphadenopathia in both cervical regions. Biopsy showed infiltration by a population of cells consistent with metastatic glioma, showing positivity for Olig2, GFAP, S100 and SOX10 and 1p/19q co-deletion. KI-67 was 40%. The diagnosis was confirmed by an independent reference center. Currently the patient is receiving a 5/28 days temozolomide monotherapy regimen with 150mg/m2. A severe isolated normocytic and normochromic anaemia occurred propable on the basis of bone marrow involvement. EM of oligodendrogliomas are rare and infrequently reported. According to literature, most common sites include bone and bone marrow, as well as lymph-nodes and pulmonary metastasis. In our case the intracerebral lesion has been stable after the last treatment with gamma knife 2012. EM occurred 19 years after presentation of the primary tumor, this is above the range (months up to ten years) described in literature.The route of dissemination remains obscure. In some cases of neurosurgical excision material has been spread by seeding, which - due to the location in the skull - is unlikely in this case. The seeding into remote parts of the skull and lymph nodes, suggest a haematogenous/lymhogenous pattern.

BackgroundThe importance of QoL and neurocognitive functions in patients with glioblastoma (GB) is above controversy by now. We followed newly diagnosed GB patients treated with radio-chemotherapy during their course of disease by continuously evaluating their quality of life (QoL) and cognitive functions.MethodsWe included consecutive patients with newly diagnosed GB from 2010 to 2013 at the Medical University of Vienna. To assess QoL the EORTC QLQ C30 and BN20 questionnaire were used. Neurocognition was measured with the NeuroCog FX. The evaluations were done 6 times every three months, beginning at the beginning of radio-chemotherapy.Results42 patients participated in this study. We also recorded QoL and neurocognition in 23 patients after the first disease progression. Patients maintained their cognitive summary score until relapse. Patients with left-sided tumors showed significant lower scores in the subscale verbal fluency than patients with right-sided tumors. The global health score of QoL decreased after the fifth evaluation (13months after diagnosis) whereas a peak of fatigue symptoms was obtained at the third evaluation. Furthermore, fatigue symptoms increased strongly 7months after diagnosis and patients’ financial difficulties were mentioned more frequently by younger patients and in patients with lower education levels.ConclusionsQoL and cognitive long-term assessments are feasible also in some patients with GB after a symptomatic progression. Our study demonstrates maintenance of QoL and cognitive summary scales before tumor progression. Moreover, it highlights subgroups according to tumor location and socioeconomic factors.

Background: Mantle-field radiotherapy (mRTx) was a well-established part of treatment in Hodgkin's lymphoma. Several publications have pointed out that late effects result in a variable distribution of atrophy of neck and shoulder muscles. The clinical distribution is confined to radiation, whereas clinical symptoms develop within several years after the radiation.

Background: Lymphoma can affect the peripheral nervous system in several ways. Although treatment related toxicity is the main cause of neuropathy, isolated neoplastic peripheral nerve lesions, either as presenting symptom, during the disease or at recurrence have been described.They often present as painful, radiating neuropathies in one extremity, but several nerves can be affected as a multiplex type.

BACKGROUND: The importance of QOL and neurocognitive functions in patients with GBM is meanwhile beyond controversy. We followed newly diagnosed patients with GBM treated according to actual standard therapy during their course of disease by additionally evaluating their QOL and cognitive functions. METHODS: We included 42 consecutive patients with newly diagnosed GBM. To assess QOL we used the EORTC QLQ C30 and BN20 questionnaire. Neurocognition was measured with the NeuroCog FX. The evaluations were done 6 times every three months, beginning at the initiation of radiotherapy. RESULTS: 21/42 patients were able to do three assessments within 7 months. Afterwards, condition deterioration led to drop outs. The cognitive summary scale showed moderate impairment but remained stable. Patients with left-sided tumors showed significant lower scores in the subscale verbal fluency than patients with right-sided tumors during 4 months. The global health score of QOL decreased 20 points after the fifth evaluation whereas perceived fatigue symptoms were already increased one assessment before. Furthermore the patientś financial difficulties due to the disease increased strongly 7 months after diagnosis and were mentioned more frequently in younger patients and in patients with lower education levels. CONCLUSION: QOL and cognitive long-term assessments are feasible in patients with GBM before symptomatic progression occurs. Our study shows maintenance of QOL and cognitive summary scales before tumor progression and highlights subgroups according to tumor location and socioeconomic factors.

e12507 Background: An increasing number of patients with Glioblastoma mulitforme (GBM) are alive up to three years after diagnosis (long-term survivors). Hence there is an urgent need for data about their clinical outcome and quality of life to optimize the medical management and function of patients. Methods: In this cross sectional study we studied 16 GBM long-term survivors treated at the outpatient clinic of the Medical University Hospital Vienna. The patients have been treated there since their diagnosis. We assessed patient's clinical outcome to get global information about the circumstances under which they live. Results: We assessed 8 female and 8 male GBM long-term survivors with a median age of 52 years (71-30). 14 of them lived together with their partner (and children) while two lived single. The mean of the summary-score of the Neuro Cog-Fx, a computerized instrument for neurocognitive assessment of patients with neurological diseases, was 88 and ranged from 70 to 111, whereas results from 61-79 are defined conspicuous, 80-89 borderline and results up to 90 normal. The global health score ranged from 17% to 100% with a mean of 68%. Drowsiness, weakness in both legs and a headache were the most stated physical problems. The Independent Activities of Daily Living – Score ranged from 0-8 points; mean was 7 points and Barthel Index resulted in 35-100 with a mean of 92 points. Six patients showed impairment in their manual dexterity, one patient in their mobility. Three patients showed conspicuous depression scores, two had conspicuous anxiety results. Furthermore, future uncertainty was stated in 12 patients. Conclusions: GBM long-term survivors show moderate impairment in their cognitive functions and often suffer from physical problems. However, the majority of the GBM long-term survivors is able to manage their activities of daily living independently. Nevertheless, global health and future prospects remain poor.