Exophytic Primary Intramedullary Spinal Cord Glioblastoma: Case Report and Critical Review of Literature

Chanchotisatien, Apisara; Xiong, Jingang; Yu, Jin‐Tai; Sh, Chu

doi:10.1016/j.wneu.2018.11.113

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…This tumor is more prone to grow in the cervical or cervicothoracic region and is associated with severe disability and poor prognosis in most patients[ 11 ]. The early symptoms of these patients are usually weakness of unilateral or bilateral limbs[ 1 , 3 , 5 ], sensorimotor disorders, and incontinence[ 6 , 12 , 13 ]. However, when accompanied by metastasis of other parts, the symptoms are usually different.…”

Section: Discussionmentioning

confidence: 99%

Atypical imaging features of the primary spinal cord glioblastoma: A case report

Li¹,

Chen²,

Li³

et al. 2022

WJCC

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BACKGROUND Primary spinal cord (PSC) glioblastoma (GB) is an extremely rare but fatal primary tumor of the central nervous system and associated with a poor prognosis. While typical tumor imaging features are generally easy to recognize, glioblastoma multiforme can have a wide range of imaging findings. Atypical GB is often misdiagnosed, which usually delays the optimal time for treatment. In this article, we discuss a clinical case of pathologically confirmed PSC GB under the guise of benign tumor imaging findings, as well as the most recent literature pertaining to PSC GB. CASE SUMMARY A 70-year-old female complained of limb weakness lasting more than 20 d. Irregular masses were observed inside and outside the left foramina of the spinal canal at C7-T1 on medical imaging. Based on the imaging features, radiologists diagnosed the patient with schwannoma. Tumor resection was performed under general anesthesia. The final histopathological findings revealed a final diagnosis of PSC GB, world health organization Grade IV. The patient subsequently underwent a 4-wk course of radiotherapy (60 Gy in 20 fractions) combined with temozolomide chemotherapy. The patient was alive at the time of submission of this manuscript. CONCLUSION Atypical GB presented unusual imaging findings, which led to misdiagnosis. Therefore, a complete recognition of imaging signs may facilitate early accurate diagnosis.

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Section: Discussionmentioning

confidence: 99%

Atypical imaging features of the primary spinal cord glioblastoma: A case report

Li¹,

Chen²,

Li³

et al. 2022

WJCC

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“…In previous case reports [13][14][15][16], patients with intramedullary primary spinal cord glioblastoma with significant exophytic growth underwent laminectomy followed by radiation therapy with temozolomide. In one case report [14], the patient had intracranial dissemination on follow-up MRI but remained alive for nine months following surgery.…”

Section: Discussionmentioning

confidence: 99%

Large Adult Spinal Diffuse Midline Histone H3 Lysine27-to-Methionine-Mutant Glioma With Intramedullary and Extramedullary Components Presenting With Progressive Hydrocephalus: A Case Report Highlighting Unique Imaging Findings and Treatment

Einstein¹,

Bonda²,

Hosseini³

et al. 2021

Cureus

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Diffuse midline glioma with histone H3 lysine27-to-methionine mutation (H3 K27M mutation) is a rare, aggressive tumor that is designated as World Health Organization (WHO) grade IV regardless of histologic features. Preoperative diagnosis remains challenging due to limited evidence regarding distinctive clinical and imaging characteristics. We describe the case of a young woman who presented with progressively worsening headaches due to communicating hydrocephalus. MR imaging with contrast of the cervical and thoracic spine revealed diffuse leptomeningeal enhancement with focal areas of intramedullary and subarachnoid T2 hyperintensity and enhancement, suggestive of a potential infectious process. Intraoperatively, no epidural pathology was identified, and with the differential diagnosis remaining broad, a second procedure was conducted involving intradural exploration and biopsy of a lesion. This was then identified as a diffuse midline glioma with H3 K27M mutation. The nonfocal clinical presentation in the setting of communicating hydrocephalus as well as the significant exophytic tumor growth and imaging findings made the initial diagnosis unique and challenging. This case, therefore, emphasizes the rare presentation of this tumor, and the need for further understanding of the clinical and imaging characteristics of this disease as well as the need for effective therapeutics.

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“…The current treatment methods for IMSCTs includes surgery, chemotherapy, and radiotherapy. 28,29 Recently, clinical advances in multi-modality treatment, such as chemotherapy combined with radiotherapy, have led to an increase in the survival rate of patients with IMSCTs. 30 In addition to these methods, gene therapy has been explored as a possible alternative approach to overcome IMSCTs.…”

Section: Discussionmentioning

confidence: 99%

Combination Therapy by Tissue-Specific Suicide Gene and Bevacizumab in Intramedullary Spinal Cord Tumor

et al. 2020

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Purpose: Malignant gliomas are aggressive spinal cord tumors. In this study, we hypothesized that combination therapy using an anti-angiogenic agent, bevacizumab, and hypoxia-inducible glioblastoma-specific suicide gene could reduce tumor growth. Materials and Methods: In the present study, we evaluated the effect of combination therapy using bevacizumab and pEpo-NI2-SV-TK in reducing the proliferation of C6 cells and tumor growth in the spinal cord. Spinal cord tumor was generated by the injection of C6 cells into the T5 level of the spinal cord. Complexes of branched polyethylenimine (bPEI)/pEpo-NI2-SV-TK were injected into the spinal cord tumor. Bevacizumab was then administered by an intraperitoneal injection at a dose of 7 mg/kg. The anti-cancer effects of combination therapy were analyzed by histological analyses and magnetic resonance imaging (MRI). The Basso, Beattie and Bresnahan scale scores for all of the treatment groups were recorded every other day for 15 days to assess the rat hindlimb strength. Results: The complexes of bPEI/pEpo-NI2-SV-TK inhibited the viability of C6 cells in the hypoxia condition at 5 days after treatment with ganciclovir. Bevacizumab was decreased in the cell viability of human umbilical vein endothelial cells. Combination therapy reduced the tumor size by histological analyses and MRI. The combination therapy group showed improved hind-limb function compared to the other groups that were administered pEpo-NI2-SV-TK alone or bevacizumab alone. Conclusion: This study suggests that combination therapy using bevacizumab with the pEpo-NI2-SV-TK therapeutic gene could be useful for increasing its therapeutic benefits for intramedullary spinal cord tumors.

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Exophytic Primary Intramedullary Spinal Cord Glioblastoma: Case Report and Critical Review of Literature

Cited by 17 publications

References 18 publications

Atypical imaging features of the primary spinal cord glioblastoma: A case report

Atypical imaging features of the primary spinal cord glioblastoma: A case report

Large Adult Spinal Diffuse Midline Histone H3 Lysine27-to-Methionine-Mutant Glioma With Intramedullary and Extramedullary Components Presenting With Progressive Hydrocephalus: A Case Report Highlighting Unique Imaging Findings and Treatment

Combination Therapy by Tissue-Specific Suicide Gene and Bevacizumab in Intramedullary Spinal Cord Tumor

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