Clinical StudyPoor prognosis despite aggressive treatment in adults with intramedullary spinal cord glioblastoma
Introduction
Spinal cord tumors account for 6–8% of central nervous system tumors and are infrequent compared to intracranial neoplasms [1]. In adults, intramedullary spinal cord tumors account for 5–10% of all spinal tumors, and approximately 90% of spinal cord tumors are of glial origin [2]. The incidence of spinal cord gliomas has been described at 0.22 per 100,000 people [3], with malignant gliomas having an incidence of about 0.12 per 100,000 [4]. The most common types are astrocytomas and ependymomas [5].
Spine involvement of glioblastoma is rare, representing 7.5% of all intramedullary gliomas and 1–3% of all spinal cord tumors [6]. In this series, we describe five adult spinal glioblastoma patients who were treated at our institution from 1990 to 2014.
Section snippets
Materials and methods
After obtaining approval from the Institutional Review Board, a retrospective review of patients with intramedullary spinal cord tumors and pathological diagnoses of glioblastoma from 1990 to 2014 was performed. Five patients were identified, and their medical charts were reviewed including operative notes, radiology reports, and pathology reports.
Demographic factors including age, sex and race were identified. Preoperative information was gathered including the presenting signs and symptoms,
Presentation
Over a 24 year period, five patients underwent surgical resection of an intramedullary glioblastoma of the spine at our institution (Table 1, Table 2). All patients were male and the median age at presentation was 31 years (range: 18–61). The median duration of symptoms was 5 months (range: 1–9). All men presented with motor and sensory dysfunction, three with pain, three with bladder dysfunction, and three with bowel dysfunction. The median McCormick score at presentation was III (range: II–III).
Discussion
We report our institution’s experience with five male patients who underwent surgery for intramedullary spinal glioblastoma and find that despite surgical treatment, the prognosis and clinical outcomes were poor.
Glioblastoma is a malignant tumor of glial cells, most commonly occurring in the brain [7] and with an average annual incidence rate of 3.2 per 100,000 people [8]. It is also the most aggressive type of primary brain tumor, often invading and infiltrating the normal parenchyma and
Conclusion
We present five men who were treated at our institution over a 24 year period for rare adult intramedullary spinal cord glioblastoma. Despite aggressive treatment, the prognosis of this tumor is poor, and we observed a median survival in our series of only 20 months. New treatment strategies must be developed to improve survival in this patient population.
Conflicts of Interest/Disclosures
The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.
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