[Spinal leptomeningeal metastasis from cerebral glioblastoma: case report].
BACKGROUND
Glioblastoma multiforme (GBM) is the most common primary malignant tumor of the central nervous system. Its tendency to infiltrate and recur locally is well known. Spinal leptomeningeal metastasis (SLM) due to a GBM are well documented at autopsy in patients previously diagnosed of GBM, however, systemic dissemination with symptomatic leptomeningeal metastasis is quite rare. Most of the time it is diagnosed late and misdiagnosis is a common problem.


METHODS
We present a case of a 65-year-old man with a right temporal GBM treated by surgical resection, radiotherapy and chemotherapy, who is readmitted 10 months later as he developed an ataxic gait. A new cerebral magnetic resonance imaging (MRI) showed multiple cerebellar metastasis. He also reported intense lumbar pain on the new admission, increasing in intensity and that was followed by flaccid paraparesis two weeks later. Multiple spinal metastasis deposits were documented by a contrast enhanced spinal MRI.


CONCLUSIONS
SLM need to be suspected in patients with a past history of intracranial GBM, who present with clinical features that can not been explained by the primary lesion. Awareness of this complication might facilitate more rapid diagnosis and treatment. A discussion is made regarding SLM in patients with GBM with reference to the medical literature.
Toledano Delgado
R
R
Servicio de Neurologia, Hospital Ramón y Cajal, Madrid.
Garcia
N
N
Riva-Amarante
E
E
Rodríguez Pascual
J
J
García Leal
R
R
Sendra Tello
J
J
D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery; D005909:Glioblastoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000556:secondary*; D009361:Neoplasm Invasiveness; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000556:secondary*