Leptomeningeal spread of intramedullary spinal cord tumors

Bell, William O.; Packer, Roger J.; Seigel, Kathy R.; Rorke, Lucy B.; Sutton, Leslie N.; Bruce, Derek A.; Schut, Luis

doi:10.3171/jns.1988.69.2.0295

Cited by 57 publications

(35 citation statements)

References 28 publications

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“…6,10,13,14 Seeding of a spinal cord glioblastoma to the brain is extremely rare. 6,13,20 In our case, a cerebral relapse occurred 4 months after the diagnosis of a spinal tumour. In the similar cases reported in the literature, the interval between the onset of spinal cord symptoms and the onset of intracranial symptoms varied from 1 week to 1 year.…”

Section: Case Reportmentioning

confidence: 51%

“…Spinal cord glioblastoma shows a tendency to spread via the subarachnoid space at the spinal and, more rarely, at the brain level. 6,13,20,21 This can be explained by the proximity of the neoplastic cells to the cerebrospinal fluid pathways. 6,13,14 However, the possibility of surgical dissemination of glioblastoma through increased exposure of the subarachnoid spaces to the malignant glial cells cannot be excluded.…”

Section: Case Reportmentioning

confidence: 99%

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Spinal glioblastoma with brain relapse in a child: clinical considerations

2005

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Case report: Spinal cord glioblastoma in children has only rarely been reported. It most frequently involves the thoracic region with a predilection for the second and third decades of life. This report describes one case of thoracic glioblastoma multiforme in a 6-year-old child and reviews other cases reported in the literature. Results: Laminectomy and excision of the tumour were performed. Postoperative radiotherapy and chemotherapy were given, but 4 months later the patient presented with a brain relapse of the tumour. At 9 months after diagnosis the patient died from cerebral tumour regrowth. Conclusions: Full neuraxis MRI is always recommended in order to detect possible metastases. The prognosis after multimodality therapy (surgery, radiotherapy, chemotherapy) remains poor. From the literature, only four cases of paediatric patients with long-term survival have been reported.

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Section: Case Reportmentioning

confidence: 51%

Section: Case Reportmentioning

confidence: 99%

Spinal glioblastoma with brain relapse in a child: clinical considerations

2005

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“…At the outset of chemotherapy, three of our patients had leptomeningeal metastases; this is a rare event in benign CNS tumours in children (Hardison et al, 1987;Bell et al, 1988;Civitello et al, 1988), being more frequent with intramedullary tumours and malignant tumours (Chamberlain, 1995). Chemotherapy induced two PR and one SD in our three children with leptomeningeal dissemination.…”

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confidence: 98%

“…Survival after leptomeningeal relapses of intramedullary tumours is poor. One of the three children reported by Bell et al (1988) was treated with systemic chemotherapy and was alive 10 months after relapsing, with stable residual disease. All the patients reported by Chamberlain in a review of the paediatric literature in 1995 (Chamberlain, 1995) died within 6 months of the onset of leptomeningeal dissemination.…”

mentioning

confidence: 99%

“…If complete resection is impossible, or if the tumour is inoperable, radiation therapy is usually recommended (Lunardi et al, 1993;O'Sullivan et al, 1994). Metastatic tumours (with leptomeningeal spread) and relapses have a poor prognosis when treated with the standard approach, and may require other forms of treatment (Bell et al, 1988;Civitello et al, 1988;Chamberlain, 1995). In the case of holocord tumours and cases involving young children, radiotherapy (RT) can have very severe sequelae (spinal deformities, growth deficits, etc.)…”

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confidence: 99%

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Chemotherapy for unresectable and recurrent intramedullary glial tumours in children

et al. 1999

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Summary Adjuvant treatment for intramedullary tumours is based on radiotherapy. The place of chemotherapy in this setting has yet to be determined. Between May 1992 and January 1998, eight children with unresectable or recurrent intramedullary glioma were treated with the BB SFOP protocol (a 16-month chemotherapy regimen with carboplatin, procarbazine, vincristine, cyclophosphamide, etoposide and cisplatin). Six children had progressive disease following incomplete surgery and two had a post-operative relapse. Three patients had leptomeningeal dissemination at the outset of chemotherapy. Seven of the eight children responded clinically and radiologically, while one remained stable. At the end of the BB SFOP protocol four children were in radiological complete remission. After a median follow-up of 3 years from the beginning of chemotherapy, all the children but one (who died from another cause) are alive. Five patients remain progression-free, without radiotherapy, 59, 55, 40, 35 and 16 months after the beginning of chemotherapy. The efficacy of this chemotherapy in patients with intramedullary glial tumours calls for further trials in this setting, especially in young children and patients with metastases.

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Extraneural metastases of infratentorial glioblastoma multiforme to the peritoneal cavity

Newton

Rosenblum

Walker

1992

Cancer

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This report describes two autopsy‐proven cases of a rare complication of infratentorial glioblastoma multiforme (GBM): metastatic seeding of the peritoneal cavity through ventriculoperitoneal (VP) shunts. Patient 1 was a 13‐year‐old boy with a pontine GBM, and Patient 2 was a 9‐year‐old girl with a thoracolumbar spinal cord GBM. Autopsy of both patients demonstrated leptomeningeal gliomatosis encasing the spinal cord and basal structures of the brain, in addition to peritoneal and omental metastases. The pattern of abdominal metastasis seen in these patients is typical of tumors that directly seed the peritoneal cavity and implicates the VP shunt as the vehicle of extraneural spread. Although a rare occurrence, extraneural metastases should be sought in patients with glioma with VP shunts who demonstrate increased abdominal girth, unexplained weight gain, or persistent abdominal pain.

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Leptomeningeal spread of intramedullary spinal cord tumors

Cited by 57 publications

References 28 publications

Spinal glioblastoma with brain relapse in a child: clinical considerations

Spinal glioblastoma with brain relapse in a child: clinical considerations

Chemotherapy for unresectable and recurrent intramedullary glial tumours in children

Extraneural metastases of infratentorial glioblastoma multiforme to the peritoneal cavity

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