title: Glioblastoma with spinal seeding.
abstract: BACKGROUND
  Extracranial seeding of glioblastoma multiforme (GBM) is very rare and its development depends on several factors. This case report describes two patients suffering from GBM with spinal seeding. In both cases, the anatomic localization of the primary tumor close to the cerebrospinal fluid (CSF) was the main factor for spinal seeding.
  
  
  METHODS
  Two patients with GBM and spinal seeding are presented. After diagnosis of spinal seeding, both patients were highly symptomatic from their spinal lesions. Case 1 experienced severe pain requiring opiates, and case 2 had paresis of lower limbs as well as urinary retention/incontinence. Both patients were treated with spinal radiation therapy. Nevertheless, they died 3 months after diagnosis of spinal seeding.
  
  
  RESULTS
  In both patients the diagnosis of spinal seeding was made at the time of cranial recurrence. Both tumors showed close contact to the CSF initially. Even though the patients underwent intensive treatment, it was not possible to keep them in a symptom-free state.
  
  
  CONCLUSIONS
  Because of short survival periods, patients deserve optimal pain management and dedicated palliative care.
authors.affiliation: Clinical Division of Oncology, Department of Medicine I, University of Vienna, Austria.
authors.forename: Negar
authors.initials: N
authors.lastname: Fakhrai
authors.forename: Thomas
authors.initials: T
authors.lastname: Czech
authors.forename: Karin
authors.initials: K
authors.lastname: Diekmann
authors.forename: Barbara
authors.initials: B
authors.lastname: Fazeny-Dörner
authors.forename: Peter
authors.initials: P
authors.lastname: Birner
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Hainfellner
authors.forename: Daniela
authors.initials: D
authors.lastname: Prayer
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D005909:Glioblastoma / Q000473:pathology* / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*