Long-term survival enhanced by cordectomy in a patient with a spinal glioblastoma multiforme and paraplegia. Case report.
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.
Marchan
Edward M
EM
Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. edmarchan@gmail.com
Sekula
Raymond F
RF
Jannetta
Peter J
PJ
Quigley
Matthew R
MR
D000998:Antiviral Agents / Q000627:therapeutic use; D002528:Cerebellar Neoplasms / Q000556:secondary; D017809:Fatal Outcome; D005909:Glioblastoma / Q000150:complications* / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010264:Paraplegia / Q000209:etiology*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D013116:Spinal Cord / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b