Abstract
A 31-year old female underwent subtotal resection of a spinal glioblastoma multiforme (GBM) at level D 10/11 in June 1997. Immunohistochemistry revealed increased MIB-1 labeling index and accumulation of p53 protein. Routine MRI in February 1998 showed multiple tumors of the lumbar spinal cord. At open biopsy, diffuse infiltration of multiple radices was seen. Histologically and immunohistochemically, the tumor was similar to the primary. In May 1998, MRI revealed multiple intracranial metastases and meningeal involvement. The patient died in June 1998, 13 months after the onset of symptoms.
The lifes of patients with spinal gliomas are not endangered by direct compression of the brain stem, and systemic metastases are extremely uncommon with gliomas. Yet, survival times in the reported case and in the literature are not better than with cerebral localization. Analysis of the present case and a survey of the literature indicate that CSF involvement and consecutive intracranial seeding determine the prognosis of patients with spinal GBM. Thus, regular monitoring of CSF-cytology and/or spinal MRI appear to be advisable in spinal GBM.
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Andrews AA, Enriques L, Renaudin J, Tomiyasu U: Spinal intramedullary glioblastoma with intracranial seeding. Report of a case. Arch Neurol 35: 244-245, 1978
Iwata K, Nakagawa H, Hashizume Y: Significance of MIB-1, PCNA indices, and p53 protein over-expression in intramedullary tumors of the spinal cord. Noshuyo Byori 13: 73-78, 1996
Grisold W, Pernetzky G, Jellinger K: Giant-cell glioblastoma of the thoracic cord. Acta Neurochir Wien 58: 121-126, 1981
Kleihues P, Cavenee WK: Astrocytic tumours. In: Pathology and Genetics of Tumours of the Nervous System. Kleihues P, Cavenee WK (eds). International Agency for Research on Cancer, Lyon, 2000, pp 16-25
Shapiro WR, Green SB, Burger PC, Mahaley-MS J, Selker RG, VanGilder JC, Robertson JT, Ransohoff J, Mealey J, Strike TA, Pistemaa DA: Randomized trial of three chemotherapy regimens and two radiotherapy regimens and two radiotherapy regimens in postoperative treatment of malignant glioma. Brain Tumor Cooperative Group Trial 8001. J Neurosurg 71: 1-9, 1989
Leifer D, Moore T, Ukena T, Wilner T, Thor A, Hedley-White E: Multifocal glioblastoma with liver metastases in the absence of surgery. J Neurosurg 71: 772-776, 1989
Helseth A, Mork SJ: Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 71: 842-845, 1989
Onda K, Tanaka R, Takahashi H, Takeda N, lkuta F: Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 25: 533-540, 1989
Yung WA, Horten BC, Shapiro WR: Meningeal gliomatosis: a review of 12 cases. Ann Neurol 8: 605-608, 1980
Ciappetta P, Salvati M, Capoccia G, Artico M, Raco A, Fortuna A: Spinal glioblastomas: report of seven cases and review of the literature. Neurosurgery 28: 302-306, 1991
Asano N, Kitamura K, Seo Y, Mukai K, Soga T, Hondo H, Matsumoto K: Spinal cord glioblastoma multiforme with intracranial dissemination-case report. Neurol Med Chir Tokyo 30: 489-494, 1990
Cursiefen S, Sommer C, Behr R et al.: lntramedullary glioblastoma multiforme with spinal intracranial seeding. J Neurol 488-488, 1998 (Abstract)
Hely M, Fryer J, Selby G: Intramedullary spinal cord glioma with intracranial seeding. J Neurol Neurosurg Psychiatry 48: 302-309, 1985
Rossberg C, Litzenberger J: Intramedullary glioblastoma multiforme with unusual, intracranial neoplastic meningeosis. Nervenarzt 59: 401-404, 1988
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 13: 301-305, 1985
Kawanishi M, Kuroiwa T, Nagasawa S, Ohta T, Oketa M, Onomura T: A case of spinal glioblastoma with intracranial dissemination. No Shinkei Geka 21: 1109-1112, 1993
O'Connell JEA: The subarachnoid dissemination of spinal tumors. J Neurol Neurosurg Psychiatry 9: 55-62, 1946
Guidetti B, Mercuri S, Vagnozzi R: Long-term results of the surgical treatment of 129 intramedullary spinal gliomas. J Neurosurg 54: 323-330, 1981
Kendrick FD, Bonnin JM, Garcia JH: Metastases of a spinal glioblastoma multiforme into an intracranial arachnoid cyst. Neurosurgery 20: 780-783, 1987
Kopelson G, Linggood RM: Intramedullary spinal cord astrocytoma versus glioblastoma: the prognostic importance of histologic grade. Cancer 50: 732-735, 1982
Chida K, Konno H, Sahara M, Takase S: Meningeal seeding of spinal cord glioblastoma multiforme without any signs of myelopathy. Rinsho Shinkeigaku 35: 1235-1240, 1995
Linstadt DE, Wara WM, Leibel SA, Gutin PH, Wilson CB, Sheline GE: Postoperative radiotherapy of primary spinal cord tumors. Int J Radiat Oncol Biol Phys 16: 1397-1403, 1989
Roessmann U, Weiss MH: Giganto-cellular glioblastoma of the lumbosacral spinal cord. Acta Neuropathol Berl 20: 264-266, 1972
Shirato H, Kamada T, Hida K, Koyanagi I, Iwasaki Y, Miyasaka K, Abe H: The role of radiotherapy in the management of spinal cord glioma. Int J Radiat Oncol Biol Phys 33: 323-328, 1995
Yamazaki-M, Ikota-T, Ohkata-N, Tashirao-T, Sawamura-Y, Iwasaki-Y, Abe-H: A case of spinal cord glioblastoma multiforme. No Shinkei Geka 20: 85-89, 1992
Yasui T, Hakuba A, Katsuyama J, Nishimura S: Microsurgical removal of intramedullary spinal cord tumours: report of 22 cases. Acta Neurochir Suppl Wien 43: 9-12, 1988
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Strik, H., Effenberger, O., Schäfer, O. et al. A Case of Spinal Glioblastoma Multiforme: Immunohistochemical Study and Review of the Literature. J Neurooncol 50, 239–243 (2000). https://doi.org/10.1023/A:1006415703881
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DOI: https://doi.org/10.1023/A:1006415703881