Abstract
Background:Symptomatic spinal metastasis from an intracranial primary glioblastoma multiforme (GBM) is very rare. Our literature search identified a total of 42 such patients of which 11 were treated with surgical decompression for spinal metastasis with only one such report from the pediatric age group. Previous studies have reported variable outcomes after surgical management.Case Description:We report the case of a 16-year-old boy who underwent surgical spinal decompression for spinal metastasis after intracranial GBM. The patient regained motor and autonomic function following surgery and reported improvement in pain. We also present findings from a literature review using the PubMed database from 1985 to June 2013 on this subject and compare radiation therapy with surgical decompression as palliative modalities in such patients.Conclusion:There are no evidence-based guidelines available on the subject and no treatment regimen has yet demonstrated survival benefit in these patients. Surgical decompression may be a better option for patients with focal resectable lesions and who are medically stable to tolerate the procedure.
Highlights
ConclusionThere are no evidence‐based guidelines available on the subject and no treatment regimen has yet demonstrated survival benefit in these patients
Symptomatic spinal metastasis from an intracranial primary glioblastoma multiforme (GBM) is very rare
Our literature search identified a total of 42 reported cases of spinal drop down metastasis following GBM and only 11 of these patients underwent a surgical spinal decompression
Summary
There are no evidence‐based guidelines available on the subject and no treatment regimen has yet demonstrated survival benefit in these patients. We review the literature on the efficacy of spinal surgical decompression on clinical outcomes in these patients and Surgical Neurology International 2014, 5:40 report and compare outcomes in patients who received surgical decompression with those who did not This 16‐year‐old male child presented with spontaneous onset of headache, nausea, and slight drowsiness since 2 weeks. Magnetic resonance imaging (MRI) showed a left parietooccipital lesion with intraventricular extension [Figure 1] Both solid and cystic components were present with calcifications marked on the medial aspect. The power was 0/5 with increased spasticity and 3+ reflexes and normal bulk in both the lower limbs.[17,25] The Babinski’s sign was positive bilaterally and the patient had lost bladder control. The family signed a do not resuscitate (DNR) form and the patient passed away 2 days later following cardiopulmonary arrest after significant brain stem herniation and extension of GBM
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