Glioblastoma multiforme in conus medullaris with intracranial metastasis after postoperative adjuvant therapy
Chengrui Yan1, Xiangyi Kong, Hua Yin
1Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, P.R. China Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, MA Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, P.R. China.
Abstract:
Spinal glioblastoma multiforme is not common among spinal cord tumors. According to our literature review, only 27 cases originating from the conus medullaris were reported. We herein reported a case of a 10-year-old child diagnosed with glioblastoma multiforme. The patient received adjuvant radiotherapy and standard temozolomide chemotherapy after total excision. Intracranial lesions were found 1 month after postoperative adjuvant therapy. We described the clinical characteristics and postoperative therapy of the patient, and reviewed all of the published cases of conus medullaris glioblastoma. Location, age, leptomeningeal spread, and secondary hydrocephalus may be predictive factors. Immunohistochemical factors such as p53 and Ki-67 are also important. Combined treatment of surgery and postoperative adjuvant therapy is commonly used, but is controversial.
Insights
Spinal glioblastoma multiforme is a rare spinal cord tumor. This case highlights predictive factors and treatment controversies for conus medullaris glioblastoma in a pediatric patient.
Area of Science:
- Neuro-oncology
- Pediatric Oncology
- Neurosurgery
Background:
- Spinal glioblastoma multiforme (GBM) is exceptionally rare, with only 27 reported cases originating from the conus medullaris.
- This study focuses on a unique pediatric case of conus medullaris GBM.
Observation:
- A 10-year-old child was diagnosed with conus medullaris GBM.
- The patient underwent total excision followed by adjuvant radiotherapy and temozolomide chemotherapy.
- Intracranial lesions developed one month post-therapy, indicating potential leptomeningeal spread.
Findings:
- Clinical characteristics, postoperative therapy, and outcomes of conus medullaris GBM were reviewed.
- Potential predictive factors include tumor location, patient age, leptomeningeal spread, and secondary hydrocephalus.
- Immunohistochemical markers like p53 and Ki-67 are significant prognostic indicators.
Implications:
- The combined treatment approach of surgery and adjuvant therapy for spinal GBM remains controversial.
- Further research is needed to establish optimal treatment strategies for this rare pediatric malignancy.
- Understanding predictive factors may improve early diagnosis and patient management for spinal GBM.
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