Treatment of Recurrent Primary Spinal Glioblastoma Multiforme—Case Report^[*]

Introduction

Primary glioblastoma multiforme (GBM) of the spinal cord is a rare lesion and makes up only about 1.5% of all spinal cord tumors.[1] Therefore, most publications are case reports. At best, small series on spinal cord tumors mention glioblastomas. Therefore, treatment always requires an individual decision-making process. In most cases, subtotal tumor resection or biopsy is followed by radiation therapy. Similar to cases of cerebral GBM, local recurrency after a few months is frequent and often is associated with cerebral dissemination. If this occurs, palliative therapy remains the only option.

The authors report on a case with an initial microsurgical resection of a primary spinal GBM located in the conus medullaris. Postoperative focal radiation therapy was performed with a dose of 54 Gy. One year after surgery, we diagnosed a recurrent tumor without any cerebral dissemination. The lesion expanded from T12 up to T5. At that time, our patient suffered from subtotal paraparesis. After an extensive discussion, we recommended a cordectomy to stop the further cranial expansion of the tumor. Our report details the course of the disease in this particular case, discusses cordectomy as a surgical option as well as high-dose irradiation as an additional treatment.

^* This article was originally published online in Central European Neurosurgery on August 12, 2011 (DOI:10.1055/s-0031-1275691)

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