CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(02): 162-164
DOI: 10.1055/s-0041-1731974
Case Report

A Rare Case of Dissemination of Primary Spinal Glioblastoma

Deniz Sirinoglu
1   Department of Neurosurgery, Prof. Dr. Cemil Tascioglu State Hospital, Istanbul, Turkey
,
1   Department of Neurosurgery, Prof. Dr. Cemil Tascioglu State Hospital, Istanbul, Turkey
,
Ozan Baskurt
1   Department of Neurosurgery, Prof. Dr. Cemil Tascioglu State Hospital, Istanbul, Turkey
,
Mehmet Volkan Aydin
1   Department of Neurosurgery, Prof. Dr. Cemil Tascioglu State Hospital, Istanbul, Turkey
› Author Affiliations

Abstract

Background Primary spinal glioblastoma is a rare lesion which constitutes only 1.5% of all spinal tumors. Diagnosis is challenging due to absence of any radiological hallmark of the disease. Even though surgery combined with chemoradiotherapy is the optimal management for these tumors, prognosis is still poor. Dissemination of glioblastoma is reported several times in the literature, which is correlated with worse prognosis and outcome. This case report that we are presenting is the first case where dissemination of primary spinal glioblastoma dissemination is limited only to spinal cord, without intracranial invasion, and regression was achieved with chemoradiotherapy.

Case Report In this article, a patient with primary spinal glioblastoma who presented with paraparesia is presented. Patient underwent surgery for resection of the tumor and received adjuvant radiotherapy. However, 9 months postoperatively, dissemination was detected in epidural and subdural spaces of spinal canal, with concomitant compression of spinal cord. There was no radiographically detected lesion in cranial MRI. He underwent second session of radiotherapy, combined with chemotherapy and steroid. Five months later, regression of metastatic disseminated lesions was observed.

Conclusion Primary spinal glioblastoma is a rare pathology and known to have a poor prognosis, notably with dissemination of the disease. Even though further biomolecular studies are necessary to explain the pathophysiology better, chemotherapy and radiotherapy may be effective in regression of disseminated lesions.



Publication History

Article published online:
15 July 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Randakevičienė G, Gleiznienė R, Basevičius A, Lukoševičius S. An extremely rare case of glioblastoma multiforme of the spinal cord. Medicina (Kaunas 2013; 49 (05) 242-245
  • 2 Chamberlain MC, Johnston SK. Recurrent spinal cord glioblastoma: salvage therapy with bevacizumab. J Neurooncol 2011; 102 (03) 427-432
  • 3 Cheng L, Yao Q, Ma L. et al. Predictors of mortality in patients with primary spinal cord glioblastoma. Eur Spine J 2020; 29 (12) 3203-3213
  • 4 Noh JH, Lee MH, Kim WS. et al. Optimal treatment of leptomeningeal spread in glioblastoma: analysis of risk factors and outcome. Acta Neurochir (Wien 2015; 157 (04) 569-576
  • 5 Sibanda Z, Farahani N, Ogbonnaya E, Albanese E. Glioblastoma multiforme: a rare case of spinal drop metastasis. World Neurosurg 2020; 144: 24-27
  • 6 Takara E, Ide M, Yamamoto M, Imanaga H, Jimbo M, Imai M. [Case of intracranial and spinal dissemination of primary spinal glioma]. No Shinkei Geka 1985; 13 (03) 301-305. Japanese. PMID: 2989721
  • 7 König SA, Roediger T, Spetzger U. Treatment of recurrent primary spinal glioblastoma multiforme–case report. J Neurol Surg A Cent Eur Neurosurg 2012; 73 (04) 256-261
  • 8 Schwaninger M, Patt S, Henningsen P, Schmidt D. Spinal canal metastases: a late complication of glioblastoma. J Neurooncol 1992; 12 (01) 93-98
  • 9 Ozgiray E, Akay A, Ertan Y, Cagli S, Oktar N, Ozdamar N. Primary glioblastoma of the medulla spinalis: a report of three cases and review of the literature. Turk Neurosurg 2013; 23 (06) 828-834