An Unusual Presentation of Spinal Giant Cell Glioblastoma in a 21-Year-Old Female.

Benjamin J Delgado,Joseph Chen,Everardo Cobos,William Stull,Ericka Rangel,Rahul Dev Polineni,Leila Moosavi

doi:10.1177/2324709619868255

Abstract

Primary spinal cord giant cell glioblastoma multiforme of the thoracic spinal cord is a rarely-diagnosed primary spinal cord tumor in comparison to neoplasms in intracranial locations. In this article, we highlight a young adult who was diagnosed with intramedullary giant cell glioblastoma, IDH wild-type, World Health Organization grade IV/IV of the thoracic spinal cord. This case report describes the treatment approach with a postsurgical combination of radiation therapy and temozolomide, which resulted in the patient to return to her baseline of health only to later develop neurological symptoms significant for a recurrence of malignancy. In a review of the literature of described cases of primary spinal cord glioblastoma multiforme, prognosis continues to be unfavorable as current treatment options of the aggressive malignancy remain absent of a cure.

Highlights

The most common types of primary spinal cord tumors are astrocytomas and ependymomas.[1]
Primary spinal cord tumors account for 2% to 4% of all primary central nervous system tumors, with one third of them located in the intramedullary compartment.[6,7]
Among the pediatric age population of patients 21-year-old and younger, intramedullary spinal cord tumors make up 1% to 10% of diagnosed central nervous system neoplasms, with astrocytomas being the most common tumor subtype of 40% to 60% of diagnosed intramedullary spinal cord tumors.[8]

Summary

Introduction

The most common types of primary spinal cord tumors are astrocytomas and ependymomas.[1]. A 21-year-old woman with no past medical history and of absent recent trauma presents with nonradiating lower back pain, bilateral lower extremity weakness with paresthesia, unsteady gait, and urine retention of 3-week duration. Her gait was normal during the first week of her symptoms. The patient was able to return to her baseline level of activity about 2 months after the initial presentation She remained asymptomatic of any neurological deficits for about 4 months after surgery, only to later develop a recurrence of left-sided lower back pain with right lower extremity pain and paresthesia

Discussion and Literature

Findings

Conclusion