Long-term survival enhanced by cordectomy in a patient with a spinal glioblastoma multiforme and paraplegia

Abstract

<jats:p>✓Spinal glioblastomas multiforme (GBMs) are rare lesions of the central nervous system with a prognosis as poor as that of their intracranial counterpart. The authors present a case of a 50-year-old man with a GBM of the spinal cord treated with surgical removal of the mass and cordectomy after the onset of paraplegia. Six years later, the patient developed hepatitis C and received interferon therapy. Six months after the start of interferon therapy, magnetic resonance imaging revealed a right cerebellar mass pathologically consistent with a GBM. Despite aggressive treatment, the patient died 1 month later. Although intracranial dissemination of spinal GBMs has been reported, this case illustrates the longest reported interval between the occurrence of a spinal GBM and its intracranial dissemination. Thus, cordectomy should be considered as a reasonable alternative in patients with complete loss of neurological function at and below the level where they harbor a malignant spinal cord astrocytoma.</jats:p>

Long-term cure of high-grade spinal cord glioma in a pediatric patient who underwent cordectomy

“…In fact, to our knowledge, the literature contains only 7 reported cases in which cordectomy was used to treat spinal cord tumors, 1,7,9,14,15,21,25 none of which involved pediatric patients.…”

“…In 2005, Raza et al 21 reported performing cordectomy in a 65-year-old patient with a recurrent atypical meningioma of the thoracic spine, although they were unable to achieve a total resection due to persistent meningeal involvement. Marchan et al 15 performed cordectomy for a spinal GBM in a 50-year-old man. Approximately 3 months after establishing the diagnosis of spinal GBM and after the patient had become progressively paraplegic despite radiotherapy and chemotherapy, Marchan and colleagues opted to undertake a spinal cordectomy rather than debulk the lesion.…”

“…Thus, there has been only a handful of reported cases in which cordectomy has been employed for spinal neoplasms. 1,7,9,14,15,21,25 Here, we present the case of a 9-year-old boy who underwent cordectomy for the treatment of a high-grade spinal glioma. The patient has been disease free in the 14 years since his diagnosis and in the 13 years since undergoing cordectomy.…”

Radiation-Induced Spinal Cord Anaplastic Astrocytoma Subsequent to Radiotherapy for Testicular Seminoma

“…An initial strategy of biopsy may be more appropriate than attempted resection for a patient with suspected radiation-induced spinal astrocytoma. 7) Cordectomy is advocated as a reasonable alternative treatment for spinal malignant astrocytoma presenting with complete deficit below the lesion, 6,9,12) for the treatment of pain, spasticity, and posttraumatic syringomyelia. 10,20,22) The effects of cordectomy for spinal malignant astrocytoma with remaining function below the lesion are unknown.…”

Primary glioblastoma multiforme of the conus medullaris with leptomeningeal metastasis

“…Rare long-term survivors have been seen with 'radiocordectomy', in which radiation above the tolerance of the spinal cord is administered at the tumour bed, although this should be reserved for patients who are already paraplegic. The two reported cases of patients who received this treatment survived for 6 and 12 years respectively [7,14].…”