title: Brain gliomas presenting with symptoms of spinal cord metastasis.
abstract: Three patients with brain gliomas (aged 41, 37, and 43 years) presented spinal cord symptoms as first neurological presentation (two cases) or at anaplastic progression (one case). Histologically, two cases were anaplastic (WHO III) astrocytomas and one anaplastic (WHO III) oligodendroglioma. The spinal surgery consisted of partial tumor resection in two cases with localized spinal cord metastasis, and tumor biopsy in another with diffuse spreading to the conus and cauda. Spinal irradiation was performed in one case. The time interval between the spinal surgery and the appearance of brain symptoms was very short (1 month or less). Two patients underwent brain surgery (tumor resection in one and stereotactic biopsy in another). The survival time was very short (2 and 3 months) in the two patients with anaplastic astrocytoma, whereas the patient with anaplastic oligodendroglioma survived 1 year after the spinal surgery. Brain gliomas may exceptionally present with symptoms of a spinal cord metastasis. The magnetic resonance imaging finding of a spinal cord enhancing lesion, particularly if associated with root enhancement, should suggest the presence of a brain glioma. In cases with a localized spinal lesion, an early spinal surgery is advised for both diagnosis and decompression of the nervous structures. However, the clinical outcome is poor and the survival time is short.
authors.affiliation: Department of Neurosciences and Reproductive and OdontostomatologicalSciences, Neurosurgical Clinic giumarin@unina.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mariniello
authors.affiliation: Department of Neurosciences and Reproductive and OdontostomatologicalSciences, Neurosurgical Clinic.
authors.forename: Carmela
authors.initials: C
authors.lastname: Peca
authors.affiliation: Department of Biomorphological and Functional Sciences, Service of Pathology.
authors.forename: Marialaura
authors.initials: M
authors.lastname: Del Basso De Caro
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Neuroradiology, "Federico II" University School of Medicine, Naples, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Carotenuto
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Neuroradiology, "Federico II" University School of Medicine, Naples, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Formicola
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Neuroradiology, "Federico II" University School of Medicine, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Elefante
authors.affiliation: Department of Neurosciences and Reproductive and OdontostomatologicalSciences, Neurosurgical Clinic.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maiuri
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000556:secondary* / Q000601:surgery*; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009837:Oligodendroglioma / Q000556:secondary* / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Brain glioma; oligodendroglioma; spinal cord metastasis; tumor progression