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Multicentric Spinal Cord Glioblastoma.

Eibar Ernesto Cabrera-Aldana1, Rafael De la Garza Ramos2, Raúl Pichardo-Bahena3

  • 1Spine Surgery Service, National Rehabilitation Institute, México City, México.

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Summary

A 40-year-old man presented with progressive quadriparesis due to spinal cord astrocytoma. Despite surgical intervention, rapid disease progression led to the patient's death, highlighting aggressive tumor behavior.

Keywords:
glioblastomamulticentricspinal cord

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Area of Science:

  • Neuro-oncology
  • Spinal Cord Imaging
  • Neurosurgery

Background:

  • A 40-year-old male experienced progressive quadriparesis over 4 months.
  • Initial brain imaging showed no abnormalities, indicating a localized spinal issue.

Observation:

  • Cervicothoracic spine MRI revealed two heterogeneously enhancing lesions (C3-C5 and T2-T4).
  • Lesion characteristics on MRI (hypointense T1, hyperintense T2) were consistent with spinal cord astrocytoma.
  • Intraoperative biopsies confirmed glioblastoma, noting hypercellularity, vascular proliferation, and peritumoral necrosis.

Findings:

  • Surgical resection was attempted but aborted due to patient instability and intraoperative neuromonitoring changes.
  • The patient showed slight upper extremity strength improvement post-operatively.
  • The patient succumbed to rapid disease progression 1.5 months after surgery.

Implications:

  • This case underscores the aggressive nature and rapid progression potential of spinal glioblastomas.
  • Early diagnosis and effective treatment strategies for spinal cord astrocytomas are critical.
  • Challenges in surgical management of spinal cord tumors due to location and tumor biology are highlighted.