Spinal metastasis from pediatric supratentorial glioblastoma: Is it the price of an extended survival? An interesting case and review of literature

Abstract

Glioblastoma (GBM) is the most common of all the primary brain tumors with a dismal prognosis. Pediatric GBM, despite being rare, is associated with a relatively better survival than the adults. However, an increased survival could subject these children to some rare events like a spinal metastasis. Herein, we report an interesting case of a 9-year-old boy who was operated on under emergent circumstances for a left fronto-temporo-insular GBM at our institute. A maximal safe resection of the tumor was achieved followed by adjuvant chemoradiation. The boy was doing well in the follow-up visits until about a year and a half after the surgery when he presented again with quadriparesis. On a cervical spine imaging, a circumferential, enhancing mass was seen draped around the cervicothoracic spinal cord, consistent with a spinal subarachnoid (leptomeningeal) metastatic deposit. We discussed the prognosis and the relatives preferred a supportive treatment. The child eventually died after 4 weeks. We discuss the literature on the incidence, pattern, and outcome of spinal metastasis from supratentorial GBM in general and the pediatric population in particular.