title: Is surgical spinal decompression for supratentorial GBM symptomatic drop down metastasis warranted? A case report and review of literature.
abstract: BACKGROUND
  Symptomatic spinal metastasis from an intracranial primary glioblastoma multiforme (GBM) is very rare. Our literature search identified a total of 42 such patients of which 11 were treated with surgical decompression for spinal metastasis with only one such report from the pediatric age group. Previous studies have reported variable outcomes after surgical management.
  
  
  METHODS
  We report the case of a 16-year-old boy who underwent surgical spinal decompression for spinal metastasis after intracranial GBM. The patient regained motor and autonomic function following surgery and reported improvement in pain. We also present findings from a literature review using the PubMed database from 1985 to June 2013 on this subject and compare radiation therapy with surgical decompression as palliative modalities in such patients.
  
  
  CONCLUSIONS
  There are no evidence-based guidelines available on the subject and no treatment regimen has yet demonstrated survival benefit in these patients. Surgical decompression may be a better option for patients with focal resectable lesions and who are medically stable to tolerate the procedure.
authors.affiliation: Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Muhammad Babar
authors.initials: MB
authors.lastname: Khan
authors.affiliation: Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Riaz
authors.affiliation: Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Muhammad Ehsan
authors.initials: ME
authors.lastname: Bari
keywords: Decompression; glioblastoma multiforme; laminectomy; metastasis; palliation; spinal cord compression; surgery