title: Paediatric spinal glioblastoma: case report and review of therapeutic strategies.
abstract: BACKGROUND
  Although uncommon, there is significant morbidity and mortality associated with paediatric spinal glioblastoma. The paucity of cases makes treatment options difficult. The current recommended standard of care is biopsy followed by adjuvant chemo-radiotherapy, with emerging data supporting the role of safe gross total resection.
  
  
  OBJECTIVE
  The purpose of this paper is to provide a single-institution case study and to discuss current and future therapeutic treatment strategies.
  
  
  METHODS
  A 14-year-old boy presented with a 2-year history of intermittent back pain with recent progressively worsening motor and sensory deficits of the right side. Pre-operative MRI revealed an enhancing intra-medullary tumour extending from C2 to C7. During the operative case, no tumour-cord margin could be identified, and the patient underwent a subtotal excision. Histopathology confirmed glioblastoma. In the subsequent weeks, the patient's clinical condition deteriorated. Adjuvant therapy was declined by the family, and the patient died 9 weeks after initial presentation.
  
  
  CONCLUSIONS
  Despite major advances in surgical techniques, peri-operative neuro-imaging as well as chemo-radiotherapy, the prognosis of a paediatric intra-medullary high-grade spinal tumour remains poor. Detailed analysis of our understanding of tumour dynamics in this patient group is important in establishing future therapeutic strategies.
authors: National Neurosurgical Centre, Beaumont Hospital, Dublin 9, Ireland. phiohalloran@rcsi.ie
authors: Philip J
authors: PJ
authors: O'Halloran
authors: Michael
authors: M
authors: Farrell
authors: John
authors: J
authors: Caird
authors: Michael
authors: M
authors: Capra
authors: David
authors: D
authors: O'Brien
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae; D017809:Fatal Outcome; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D011859:Radiography; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*