[A case of spinal cord glioblastoma multiforme].
A 35-year-old woman was admitted to our hospital with a 3 month history of progressive paraparesis and impairment of bowel and bladder function. MRI suggested a malignant glioma at the level of T9 to L1. Laminectomy and subtotal removal of the tumor was performed. The surgical specimen was a glioblastoma multiforme. An aggressive adjuvant therapy was scheduled to prevent rapid local regrowth and leptomeningeal dissemination. Radiotherapy with a total dose of 65Gy was delivered with chemotherapy including ACNU (2mg/kg) and vincristine (0.2mg/kg). Lymphokine-activated killer (LAK) cells were given intrathecally with a total dose of 1.6 x 10(9) LAK cells with 3 x 10(4) units of IL-2. MRI taken 6 months after surgery revealed no residual tumor, and no malignant cell was detected in the patient's CSF. After physiotherapy, she became able to walk with a stick and was discharged. Chemotherapy (ACNU 2mg/kg/8 weeks) had been further continued for 2 years. She did well until 14 months after surgery, when paraparesis recurred and rapidly progressed to completism. MRI revealed a spinal cord swelling with marked edema, suggesting delayed radiation necrosis. Two years after surgery, MRI showed a marked atrophy of the spinal cord, and no residual tumor. But 3 years after surgery, a round tumor at the level of T11 and T12 was revealed on MRI, and she was admitted to our hospital again. A spinal cord amputation was performed, and the tumor was totally removed without worsening her neurological symptoms. Surgical specimen of the tumor was glioblastoma multiforme again.(ABSTRACT TRUNCATED AT 250 WORDS)
Yamazaki
M
M
Department of Neurosurgery, Hokkaido Kin-ikyo Central Hospital, Sapporo, Japan.
Ikota
T
T
Ohkata
N
N
Tashiro
T
T
Sawamura
Y
Y
Iwasaki
Y
Y
Abe
H
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000601:surgery* / Q000628:therapy; D006801:Humans; D016219:Immunotherapy, Adoptive; D015979:Killer Cells, Lymphokine-Activated / Q000637:transplantation; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000628:therapy; D015376:Nimustine / Q000008:administration & dosage; D013120:Spinal Cord Neoplasms / Q000601:surgery* / Q000628:therapy; D014750:Vincristine / Q000008:administration & dosage
D015376:Nimustine; D014750:Vincristine