Mixed malignant glioblastoma and schwannoma in spinal cord with metachronous ependymoma: A case report

Abstract

Here, we report a very rare case of mixed spinal tumor comprising of malignant glioblastoma and schwannoma, who was initially treated with tumor resection and adjuvant chemoradiation, but relapsed three years later with grade 3 ependymoma.

Primary Spinal Cord Glioblastoma

“…Their clinical characteristics depend on the location and extent of the spinal cord, and the most common reported symptom is pain. Our patient had a three-month history of pain, numbness, and progressive decrease of muscle strength in extremities [3]. MRI is considered the gold standard imaging technique to diagnose primary spinal cord GBM, it shows T2 hyperintense infiltrating lesions with heterogeneous enhancement after contrast material injection in T1-weighted sequences; differential diagnosis with other intramedullary tumors is difficult [6][7]17], so the definitive diagnosis is determined with a pathological examination, in this case ependymoma was considered.…”

“…Primary spinal cord glioblastoma multiforme (GBM) is a CNS tumor that is clinically, histologically, and genetically heterogeneous, and is a rare tumor type accounting for 1% to 5% of all glioblastomas and only 1.5% of all tumors of the spinal cord [1][2][3].…”

“…This tumor occurs particularly in younger patients (mean: 26 years old), is a little more common in men [1,4], and chiefly occurs in the cervical and thoracic spine [1,5]. Its clinical manifestations depend on the location and extent of the disease [3]. MRI and histopathological examination are indispensable for establishing the diagnosis [6][7].…”

Primary spinal glioblastoma multiforme: a case report

“…Bevacizumab (BEV) a humanised monoclonal antibody against vascular Syed AS et al Int Surg J. 2024 Jun;11 (6):1023-1026 endothelial growth factor A (VEGF-A) has potential benefits. 19 Some authors have proposed an intrathecal regime of interferon-β via an ommaya reservoir.…”

“…5 Clinical manifestations are dependent almost entirely upon the location and extent othethe tumour. 6 Currently the most recommended management is similar to that of its intracranial counterpart, which consists of surgical excision along with adjuvant temozolamide and RT. 7 However, despite prompt intervention it has an aggressive course and an invariably dreadful prognosis such that the median survival is estimated at just ~11 months.…”