Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme

Intracranial glioblastoma multiforme (GBM) constitutes the most frequent and unfortunately aggressive primary central nervous system malignancy. Despite the high tendency of these tumors to show local relapse within the brain after primary therapy, dissemination into the spinal axis is an infrequent...

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Main Authors: Lucas Serrano, Eleftherios Archavlis, Elke Januschek, Pavel Timofeev, Peter Ulrich
Format: Article
Language:English
Published: Karger Publishers 2017-03-01
Series:Case Reports in Oncology
Subjects:
Online Access:http://www.karger.com/Article/FullText/464279
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spelling doaj-33820ee0923b43138ecde96d058b50362020-11-24T23:41:23ZengKarger PublishersCase Reports in Oncology1662-65752017-03-0110128128910.1159/000464279464279Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma MultiformeLucas SerranoEleftherios ArchavlisElke JanuschekPavel TimofeevPeter UlrichIntracranial glioblastoma multiforme (GBM) constitutes the most frequent and unfortunately aggressive primary central nervous system malignancy. Despite the high tendency of these tumors to show local relapse within the brain after primary therapy, dissemination into the spinal axis is an infrequent event. If spinal metastases occur they are leptomeningeal in the vast majority of cases and always in the context of intracranial progressive disease. Spinal intramedullary metastases of intracranial GBM have rarely been described to date. We report the unique case of a young woman with subacute progressive paraparesis due to spinal intramedullary metastases of a temporal lobe GBM despite the remarkable absence of intracranial tumor relapse. The patient had undergone gross total resection of a left temporal GBM in contact with the ventricles and cisternal space followed by radio- and chemotherapy 13 months before. At the moment of diagnosis of spinal intramedullary metastases, there were no signs of intracranial tumor recurrence as revealed by MRI scans. Since a high level of suspicion may be needed to detect this rare evolution of intracranial GBM and other differential diagnoses must be ruled out at presentation, we discuss the important features of this case regarding clinical manifestation, diagnosis, surgery, and management. Furthermore, we mention possible factors that may have contributed to the development of these metastases in the context of intracranial remission.http://www.karger.com/Article/FullText/464279Spinal intradural intramedullary disseminationTemporal lobe glioblastoma multiforme
collection DOAJ
language English
format Article
sources DOAJ
author Lucas Serrano
Eleftherios Archavlis
Elke Januschek
Pavel Timofeev
Peter Ulrich
spellingShingle Lucas Serrano
Eleftherios Archavlis
Elke Januschek
Pavel Timofeev
Peter Ulrich
Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
Case Reports in Oncology
Spinal intradural intramedullary dissemination
Temporal lobe glioblastoma multiforme
author_facet Lucas Serrano
Eleftherios Archavlis
Elke Januschek
Pavel Timofeev
Peter Ulrich
author_sort Lucas Serrano
title Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
title_short Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
title_full Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
title_fullStr Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
title_full_unstemmed Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Multiforme
title_sort spinal intradural intramedullary dissemination in the absence of intracranial relapse of a previously radically treated temporal lobe glioblastoma multiforme
publisher Karger Publishers
series Case Reports in Oncology
issn 1662-6575
publishDate 2017-03-01
description Intracranial glioblastoma multiforme (GBM) constitutes the most frequent and unfortunately aggressive primary central nervous system malignancy. Despite the high tendency of these tumors to show local relapse within the brain after primary therapy, dissemination into the spinal axis is an infrequent event. If spinal metastases occur they are leptomeningeal in the vast majority of cases and always in the context of intracranial progressive disease. Spinal intramedullary metastases of intracranial GBM have rarely been described to date. We report the unique case of a young woman with subacute progressive paraparesis due to spinal intramedullary metastases of a temporal lobe GBM despite the remarkable absence of intracranial tumor relapse. The patient had undergone gross total resection of a left temporal GBM in contact with the ventricles and cisternal space followed by radio- and chemotherapy 13 months before. At the moment of diagnosis of spinal intramedullary metastases, there were no signs of intracranial tumor recurrence as revealed by MRI scans. Since a high level of suspicion may be needed to detect this rare evolution of intracranial GBM and other differential diagnoses must be ruled out at presentation, we discuss the important features of this case regarding clinical manifestation, diagnosis, surgery, and management. Furthermore, we mention possible factors that may have contributed to the development of these metastases in the context of intracranial remission.
topic Spinal intradural intramedullary dissemination
Temporal lobe glioblastoma multiforme
url http://www.karger.com/Article/FullText/464279
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