Multicentric Spinal Cord Glioblastoma

A 40-year-old man was referred to our center with a 4-month history of progressive quadriparesis. Previous brain imaging revealed no abnormality. Magnetic resonance imaging (MRI) with contrast of the cervicothoracic spine revealed 2 heterogeneously enhancing lesions at the level of C3-C5 and T2-T4 (A); T1- and T2-weighted MRI showed hypointense and hyperintense lesions, respectively, which is characteristic of spinal cord astrocytoma (B and C). Intraoperative biopsies supported the diagnosis of glioblastoma (hypercellularity, vascular proliferation, and tumor cell palisading around necrosis) (D). Though resection was attempted, surgery was aborted due to hemodynamic instability and signal changes in neuromonitoring. The patient stabilized in the intensive care unit and experienced slight improvement in upper extremity strength. After discharge without further complications, the patient was expected to return for further adjuvant therapy/surgical planning but unfortunately passed away 1.5 months after his operation, most likely to rapid disease progression.