Lumbosacral glioblastoma and leptomeningeal gliomatosis complicating the course of a cervicothoracic astrocytoma WHO grade II.
METHODS
The reported female patient underwent sub-total resection of an intra-medullary cervicothoracic astrocytoma classified as WHO grade II in 1984 at the age of 18 months and received local irradiation. In 1989, a local recurrence was diagnosed and a partial resection was performed. Sixteen years later, a small recurrent cervicothoracic tumour was found and spinal seeding to the equine nerve roots and the left cerebellar cortex was apparent on MRI. The patient was implanted with a ventriculoperitoneal shunt for a pseudo-tumour cerebri producing papilloedema, which eventually lead to amaurosis. After an extended biopsy, the invasive lumbosacral tumour was classified as glioblastoma multiforme. Two months later, the patient died after rapid progression of the caudal cranial nerve dysfunction.


CONCLUSIONS
Anaplastic progression and dissemination of spinal astrocytomas even two decades after initial diagnosis and treatment are rare. Therapies and diagnostic follow-up strategies are discussed.
Klase
Daniel
D
Department of Neurosurgery, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. daniel.klase@uk-sh.de
Gottschalk
Stefan
S
Reusche
Erich
E
Hagel
Christian
C
Goebel
Einar
E
Tronnier
Volker
V
Giese
Alf
A
D000328:Adult; D001254:Astrocytoma / Q000150:complications* / Q000473:pathology; D001416:Back Pain / Q000209:etiology; D001766:Blindness / Q000150:complications / Q000473:pathology; D002557:Cerebrospinal Fluid Shunts; D005123:Eye / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005909:Glioblastoma / Q000150:complications* / Q000473:pathology; D006801:Humans; D008141:Lordosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications* / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000150:complications; D010902:Pituitary Gland / Q000473:pathology; D011559:Pseudotumor Cerebri / Q000473:pathology / Q000503:physiopathology; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000473:pathology