A Case Report of Conus Medullaris Tumor Causing a Diagnostic Dilemma

Abstract

Intramedullary astrocytomas of the spinal cord are rarer than intracranial astrocytomas. Glioblastoma Multiforme (GBM) generally does not involve the spinal cord (1-5% of all GBM cases) and presents as only 1.5% of all spinal cord tumors. The ratio of low-grade to high-grade astrocytomas in the spinal cord is about 3:1. Case Report: We report a case of a 40-year-old male patient complaining of back pain. Insidious in onset, gradual in progression, deep-seated since 8 months. Walking has been difficult for 6 months due to associated foot drop in the left lower limb. There was no evidence of bowel or bladder involvement, and there were no complaints in the upper limbs or elsewhere. On examination, the motor system showed foot drop and EHL weakness in the left lower limb. Following that, he underwent D12-L1 laminectomy with subtotal excision of the lesion under neuromonitoring. Glioma was discovered on histopathology. Adjuvant radiation and chemotherapy were given. Conclusion: The rarity of this entity may have hampered the development of standardized regimens for optimal treatment. We believe that accumulated experience in the treatment of this lethal condition might contribute well to improving its therapeutic outcome.