Case reportDistant spread of a supratentorial glioblastoma to the spinal cord
Introduction
Glioblastomas are aggressive tumours with a poor prognosis. Although highly infiltrative tumours, they rarely spread beyond the brain. Here, we report the case of extra-cranial spread to the spinal cord from a previously well-controlled glioblastoma.
Section snippets
Case report
A 48 year-old male presented with a 5–6 week history of progressively decreasing lower limb sensation, urinary retention and gait disturbance. He had a known radiologically-stable left temporal lobe glioblastoma, which had been debulked three years prior, and was receiving bevacizumab chemotherapy at the time. Neurological exam showed normal tone and power in both lower limbs, but markedly diminished sensation to light touch on the left; patellar and Achilles reflexes were concomitantly
Discussion
Unlike their intracranial counterparts, spinal cord gliomas have not been associated with IDH1 mutations [2]. As such, the presence of IDH1 mutations in both masses allows us to confidently conclude that the spinal lesion has spread from the temporal lobe glioblastoma, despite this being a rare phenomenon. The pathway of extra-cranial spread can be leptomeningeal, along white matter tracts or haematogenous. Leptomeningeal spread of glioblastoma is rarely clinically apparent [3], [4], though
Conclusions
Symptomatic spinal cord spread is a rare complication of glioblastoma, but an important differential to be considered in the context of symptoms referrable to the spinal cord, especially in patients with longer survival.
Disclosure/conflicts of interest
None.
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