Concurrent Brain and Spine Involvement in Glioblastoma Multiforme in a Patient Presenting with Quadriparesis: A Case Report
Iman Roohbakhsh Arfaee, Reza Zare, Farzad Bidouei, Mahmoud Sarafraz, Hamid-Reza Hashemian
Department of Research and Education, Cancer Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
Med Sci Case Rep 2017; 4:50-55
Glioblastoma multiforme accounts for 55/4% of all glial neoplasms in the United States and it is the most common and most aggressive primary malignancy of the brain. Glioblastomas most often present as a single supratentorial parenchymal lesion and multiple and infratentorial GBM is a very rare clinical entity, so therapeutic experience with this type of tumor is limited.
CASE REPORT: We describe a case of GBM with concurrent involvement of the brain and spine at the time of diagnosis. He presented to our neurosurgery clinic with back pain and rapidly progressive weakness of limbs. He underwent surgery and adjuvant concurrent chemo-radiation. He achieved a good clinical response.
CONCLUSIONS: Clinicians should suspect spinal GBM in any patient with intracranial GBM and/or signs of spinal cord compression, as intracranial GBM can be clinically manifested with spinal cord metastases. Standard treatment of GBM consists of maximal surgical resection, radiotherapy, and concomitant and adjuvant chemotherapy with temozolomide. Since prognosis for patients with glioblastoma is generally poor, improvement of current modes of treatment and innovation of new treatment modalities, such as maximal resection with fluorescence-guided surgery (FGS), immunotherapy, gene therapy, and viral vectors, are necessary to improve the survival rate and ensure better quality of life.
Keywords: Glioblastoma, Spinal Cord Compression, Spinal Cord Neoplasms