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J Neurol Surg A Cent Eur Neurosurg 2012; 73(04): 256-261
DOI: 10.1055/s-0032-1313634
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

S. A. König
1   Klinikum Karlsruhe, Neurosurgery, Karlsruhe, Germany
,
T. Roediger
2   St. Gertrauden-Krankenhaus, Neurosurgery, Berlin, Germany
,
U. Spetzger
1   Klinikum Karlsruhe, Neurosurgery, Karlsruhe, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
23 July 2012 (online)

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See also:

Treatment of Recurrent Primary Spinal Glioblastoma Multiforme. Case ReportCent Eur Neurosurg 2011; 72(S 01): e23-e23
DOI: 10.1055/s-0031-1275691

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)


 

  • References

  • 1 Andrews AA, Enriques L, Renaudin J , et al. Spinal intramedullary glioblastoma with intracranial seeding. Report of a case. Arch Neurol 1978; 35 (4) 244-245
    CrossrefPubMedGoogle Scholar
  • 2 Asano N, Kitamura K, Seo Y , et al. Spinal cord glioblastoma multiforme with intracranial dissemination – case report. Neurol Med Chir 1990; 30 (7) 489-494
    CrossrefPubMedGoogle Scholar
  • 3 Ciappetta P, Salvati M, Capoccia G , et al. Spinal glioblastomas: report of seven cases and review of the literature. Neurosurgery 1991; 28 (2) 302-306
    CrossrefPubMedGoogle Scholar
  • 4 Cohen AR, Wisoff JH, Allen JC , et al. Malignant astrocytomas of the spinal cord. J Neurosurg 1989; 70 (1) 50-54
    CrossrefPubMedGoogle Scholar
  • 5 Claus D, Sieber E, Engelhardt A , et al. Ascending central nervous spreading of a spinal astrocytoma. J Neurooncol 1995; 25 (3) 245-250
    CrossrefPubMedGoogle Scholar
  • 6 Giese A, Bock HC, Kantelhardt SR , et al. Risk management in the treatment of malignant gliomas with BCNU wafer implants. Cen Eur Neurosurg 2011; 72 (1) 15-21
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Grisold W, Pernetzky G, Jellinger K. Giant-cell glioblastoma of the thoracic cord. Acta Neurochir 1981; 58 ((1–2)) 121-126
    CrossrefPubMedGoogle Scholar
  • 8 Katoh N, Shirato H, Aoyama H , et al. Hypofractionated radiotherapy boost for dose escalation as a treatment option for high-grade spinal cord astrocytic tumor. J Neurooncol 2006; 78 (1) 63-69
    CrossrefPubMedGoogle Scholar
  • 9 Kawanishi M, Kuroiwa T, Nagasawa S , et al. A case of spinal glioblastoma with intracranial dissemination [in Japanese]. No Shinkei Geka 1993; 21 (12) 1109-1112
    PubMedGoogle Scholar
  • 10 Kendrick FD, Bonnin JM, Garcia JH. Metastases of a spinal glioblastoma multiforme into an intracranial arachnoid cyst. Neurosurgery 1987; 20 (5) 780-783
    CrossrefPubMedGoogle Scholar
  • 11 Marchan EM, Sekula RF, Jannetta PJ , et al. Long-term survival enhanced by cordectomy in a patient with a spinal glioblastoma multiforme and paraplegia. Case report. J Neurosurg Spine 2007; 7 (6) 656-659
    CrossrefPubMedGoogle Scholar
  • 12 Medhkour A, Chan M. Extremely rare glioblastoma multiforme of the conus medullaris with holocord and brain stem metastases, leading to cranial nerve deficit and respiratory failure: a case report and review of the literature. Surg Neurol 2005; 63 (6) 576-582
    CrossrefPubMedGoogle Scholar
  • 13 Mendonça R, Lima LG, Fernandes LN , et al. Primary conus medullaris glioblastoma: case report [in Portuguese]. Arq Neuropsiquiatr 2005; 63 ((2B)) 539-542
    CrossrefPubMedGoogle Scholar
  • 14 Merchant TE, Nguyen D, Thompson SJ , et al. High-grade pediatric spinal cord tumors. Pediatr Neurosurg 1999; 30 (1) 1-5
    CrossrefPubMedGoogle Scholar
  • 15 Mortara R, Parker JC, Brooks WH. Glioblastoma multiforme of the spinal cord. Surg Neurol 1974; 2 (2) 115-119
    PubMedGoogle Scholar
  • 16 Nakamura M, Ishii K, Watanabe K , et al. Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Spinal Cord 2008; 46 (4) 282-286
    CrossrefPubMedGoogle Scholar
  • 17 Ng C, Fairhall J, Rathmalgoda C , et al. Spinal cord glioblastoma multiforme induced by radiation after treatment for Hodgkin disease. Case report. J Neurosurg Spine 2007; 6 (4) 364-367
    CrossrefPubMedGoogle Scholar
  • 18 Nishio S, Morioka T, Fujii K , et al. Spinal cord gliomas: management and outcome with reference to adjuvant therapy. J Clin Neurosci 2000; 7 (1) 20-23
    CrossrefPubMedGoogle Scholar
  • 19 Roessmann U, Weiss MH. Giganto-cellular glioblastoma of the lumbosacral spinal cord. Acta Neuropathol 1972; 20 (3) 264-266
    CrossrefPubMedGoogle Scholar
  • 20 Rossberg C, Litzenberger J. Intramedulläres Glioblastoma multiforme mit ungewöhnlicher, intrakranieller Meningeosis neoplastica [in German]. Nervenarzt 1988; 59 (7) 401-404
    PubMedGoogle Scholar
  • 21 Santi M, Mena H, Wong K , et al. Spinal cord malignant astrocytomas. Clinicopathologic features in 36 cases. Cancer 2003; 98 (3) 554-561
    CrossrefPubMedGoogle Scholar
  • 22 Scarrow AM, Rajendran P, Welch WC. Glioblastoma multiforme of the conus medullaris. Clin Neurol Neurosurg 2000; 102 (3) 166-167
    CrossrefPubMedGoogle Scholar
  • 23 Shirato H, Kamada T, Hida K , et al. The role of radiotherapy in the management of spinal cord glioma. Int J Radiat Oncol Biol Phys 1995; 33 (2) 323-328
    CrossrefPubMedGoogle Scholar
  • 24 Strik HM, Effenberger O, Schäfer O , et al. A case of spinal glioblastoma multiforme: immunohistochemical study and review of the literature. J Neurooncol 2000; 50 (3) 239-243
    CrossrefPubMedGoogle Scholar
  • 25 Takara E, Ide M, Yamamoto M , et al. Case of intracranial and spinal dissemination of primary spinal glioma [Article in Japanese]. No Shinkei Geka 1985; 13 (3) 301-305
    PubMedGoogle Scholar
  • 26 Yamazaki M, Ikota T, Ohkata N , et al. A case of spinal cord glioblastoma multiforme [in Japanese]. No Shinkei Geka 1992; 20 (1) 85-89
    PubMedGoogle Scholar