Spinal glioblastoma with brain relapse in a child: clinical considerations

Abstract

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.

Irradiation of Pediatric High-Grade Spinal Cord Tumors

“…3, 10, 14–16 Grade IV spinal cord tumors have a dismal prognosis, and only a handful of reports in the literature have documented long-term survivors with spinal GBM. 17 Our data is consistent with this observation, as there were no long-term survivors among our cohort of children with grade IV spinal tumors. Although the overall and progression-free survival outcomes did not reach statistical significance when stratified by histology, local failure was statistically worse for grade IV tumors than for grade III tumors.…”

Pediatric spinal glioblastoma multiforme: current treatment strategies and possible predictors of survival

“…Rates as high as 47-58% have been reported [24]. Given this possibility, evaluation of a patient with an intramedullary mass should prompt an MRI with and without gadolinium of the entire neuraxis [25]. Extra-axial spread of pediatric GBM-as was observed in one of our patients-has also been reported [3].…”

Cervical spinal glioblastoma multiforme in the elderly

“…Imaging of the whole neuroaxis is recommended to detect possible seeding,2 7 more often reported in children. Over half of high-grade gliomas of the spinal cord spread through the neuroaxis,8 possibly due to the proximity of the neoplastic cells to the cerebrospinal fluid pathways 2. This can be misleading, and in our case, the presence of foci of dissemination within the cranial and spinal compartments on imaging led to an impression of metastatic disease from an extra-central nervous system primary.…”

“…While there is predilection towards cervical location in younger patients,2 only two descriptions of cervical GBM (CGBM) have been published in the elderly 3 4. Best treatment for CGBM remains unclear.…”