Case Report
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Spinal Cord Involvement of Glioblastoma Multiforme in an Adult Patient: A Case Report

Year 2023, Volume: 2 Issue: 3, 24 - 27, 30.09.2023
https://doi.org/10.59518/farabimedj.1232513

Abstract

Glioblastoma Multiforme is a primary malignant neoplasm of the central nervous system which has aggressive progression and mostly seen in adults. Literature accepts the treatment for Glioblastoma Multiforme as combined process of surgical, concurrent chemo-radiotherapy, adjuvant chemotherapy. Glioblastoma Multiforme can spread in a variety of ways. Intraparenchymal spread by using white matter tracts is the most known way of spreading. Dissemination of Glioblastoma Multiforme through cerebrospinal fluid can happen, causing drop metastases, leptomeningeal spread and spinal metastasis. Treatment guideline for leptomeningeal spread in patients with Glioblastoma Multiforme has never been prepared. However, complete surgical removal of the tumor is the accepted treatment of Glioblastoma Multiforme. Surgical treatment is an important option in patients with spinal cord compression with solitary metastases. However, palliative radiotherapy and chemotherapy can be used in the treatment of patients with extensive spinal canal involvement and spinal cord compression. We present a case in which we applied radiotherapy because of spinal cord metastasis that developed after Glioblastoma Multiforme treatment in an adult patient. Through these observations, we analyze therapeutic options of Glioblastoma Multiforme with spinal cord involvement.

References

  • Lawton CD, Nagasawa DT, Yang I, Fessler RG, Smith ZA. Leptomeningeal spinal metastases from glioblastoma multiforme: treatment and management of an uncommon manifestation of disease. J Neurosurg Spine. 2012; 17(5): 438-448. DOI: 10.3171/2012.7.SPINE12212.
  • Grah JJ, Katalinic D, Stern-Padovan R, et al. Leptomeningeal and intramedullary metastases of glioblastoma multiforme in a patient reoperated during adjuvant radiochemotherapy. World J Surg Oncol. 2013; 11: 55. DOI: 10.1186/1477-7819-11-55.
  • Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009 [published correction appears in Neuro Oncol. 2013 May;15(5):646-7]. Neuro Oncol. 2012; 14 Suppl 5(Suppl 5): v1-v49. DOI: 10.1093/neuonc/nos218.
  • Rigau V, Zouaoui S, Mathieu-Daudé H, et al. French brain tumor database: 5-year histological results on 25 756 cases. Brain Pathol. 2011; 21(6): 633-644. DOI: 10.1111/j.1750-3639.2011.00491.x.
  • Kandaz M, Bahat Z, Guler CO, et al. Outcomes of Treatment for Glioblastoma Multiforme in Adult Patients: A Single Institution Experience from the Eastern Black Sea Region of Turkey. Uluslararası Hematoloji-Onkoloji Dergisi. 2018; 28(1): 30-35.
  • Cunha MLVD, Maldaun MVC. Metastasis from glioblastoma multiforme: a meta-analysis. Rev Assoc Med Bras (1992). 2019; 65(3): 424-433. DOI: 10.1590/1806-9282.65.3.424.
  • Jang C, Cho BK, Hwang SH, Shin HJ, Yoon SH. Leptomeningeal Spread at the Diagnosis of Glioblastoma Multiforme: A Case Report and Literature Review. Brain Tumor Res Treat. 2022; 10(3): 183-189. DOI: 10.14791/btrt.2022.0013.
  • Birzu C, Tran S, Bielle F, et al. Leptomeningeal Spread in Glioblastoma: Diagnostic and Therapeutic Challenges. Oncologist. 2020; 25(11): e1763-e1776. DOI: 10.1634/theoncologist.2020-0258.
  • Mandel JJ, Yust-Katz S, Cachia D, et al. Leptomeningeal dissemination in glioblastoma; an inspection of risk factors, treatment, and outcomes at a single institution. J Neurooncol. 2014; 120(3): 597-605. DOI: 10.1007/s11060-014-1592-1.
  • Zhao KH, Zhang C, Bai Y, et al. Antiglioma effects of cytarabine on leptomeningeal metastasis of high-grade glioma by targeting the PI3K/Akt/mTOR pathway. Drug Des Devel Ther. 2017; 11: 1905-1915. DOI: 10.2147/DDDT.S135711.
  • Minniti G, Niyazi M, Alongi F, Navarria P, Belka C. Current status and recent advances in reirradiation of glioblastoma. Radiat Oncol. 2021; 16(1): 36. DOI: 10.1186/s13014-021-01767-9.
  • Chinot OL, Wick W, Mason W, et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl J Med. 2014; 370(8): 709-722. DOI: 10.1056/NEJMoa1308345.
  • Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005; 352(10): 987-996. DOI: 10.1056/NEJMoa043330.
  • Choi PP, Shapera S. What's your call? Drop metastases. CMAJ. 2006; 175(5): 475-477. DOI: 10.1503/cmaj.060308.
  • Liu J, Shen L, Tang G, et al. Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review. J Int Med Res. 2020; 48(6): 300060520930459. DOI: 10.1177/0300060520930459.
  • Sun Q, Xu R, Xu H, Wang G, Shen X, Jiang H. Extracranial metastases of high-grade glioma: the clinical characteristics and mechanism. World J Surg Oncol. 2017; 15(1): 181. DOI: 10.1186/s12957-017-1249-6.
  • Bae JS, Yang SH, Yoon WS, Kang SG, Hong YK, Jeun SS. The clinical features of spinal leptomeningeal dissemination from malignant gliomas. J Korean Neurosurg Soc. 2011; 49(6): 334-338. DOI: 10.3340/jkns.2011.49.6.334.
  • Autran D, Barrie M, Matta M, et al. Leptomeningeal Gliomatosis: A Single Institution Study of 31 Patients. Anticancer Res. 2019; 39(2): 1035-1041. DOI: 10.21873/anticanres.13210.
  • Vertosick FT Jr, Selker RG. Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery. 1990; 27(4): 516-522. DOI: 10.1097/00006123-199010000-00002.
  • Hersh AM, Lubelski D, Theodore N. Management of Glioblastoma Metastatic to the Vertebral Spine. World Neurosurg. 2022; 161: 52-53. DOI: 10.1016/j.wneu.2022.01.074.
  • Birbilis TA, Matis GK, Eleftheriadis SG, Theodoropoulou EN, Sivridis E. Spinal metastasis of glioblastoma multiforme: an uncommon suspect?. Spine (Phila Pa 1976). 2010; 35(7): E264-E269. DOI: 10.1097/BRS.0b013e3181c11748.
  • Shahideh M, Fallah A, Munoz DG, Loch Macdonald R. Systematic review of primary intracranial glioblastoma multiforme with symptomatic spinal metastases, with two illustrative patients. J Clin Neurosci. 2012; 19(8): 1080-1086. DOI: 10.1016/j.jocn.2011.09.024.
  • Coşar M, Bıkmaz K, İplikcioğlu AK, Başocak K, Ceylan D. İntrakranyal Glioblastoma Multiforme’nin Spinal Seeding şeklinde Metastazı: Olgu Sunumu. Türk Nöroşirürji Dergisi. 2004; 14(2): 111-115.

Yetişkin Bir Hastada Glioblastoma Multiforme’nin Spinal Kord Tutulumu: Bir Olgu Sunumu

Year 2023, Volume: 2 Issue: 3, 24 - 27, 30.09.2023
https://doi.org/10.59518/farabimedj.1232513

Abstract

Glioblastoma Multiforme, merkezi sinir sisteminin agresif progresyon gösteren ve çoğunlukla erişkinlerde görülen primer malign neoplazmıdır. Literatür, Glioblastoma Multiforme tedavisini cerrahi, eş zamanlı kemo-radyoterapi ve adjuvan kemoterapinin kombine süreci olarak kabul etmektedir. Glioblastoma Multiforme çeşitli yollarla yayılabilir. Beyaz cevher yolları kullanılarak intraparenkimal yayılım en bilinen yayılma şeklidir. Glioblastoma Multiforme'un beyin omurilik sıvısı yoluyla yayılması, damla metastazlarına, leptomeningeal yayılmaya ve spinal metastaza neden olabilir. Glioblastoma Multiforme hastalarında leptomeningeal yayılım için tedavi rehberi hiç hazırlanmamıştır. Bununla birlikte, tümörün cerrahi olarak çıkarılması, Glioblastoma Multiforme'un kabul edilen tedavisidir. Soliter metastazı olan omurilik basısı olan hastalarda cerrahi tedavi önemli bir seçenektir. Ancak yaygın spinal kanal tutulumu ve spinal kord basısı olan hastaların tedavisinde palyatif radyoterapi ve kemoterapi kullanılabilir. Erişkin bir hastada Glioblastoma Multiforme tedavisi sonrası gelişen omurilik metastazı nedeniyle radyoterapi uyguladığımız bir olguyu sunuyoruz. Bu gözlemler sayesinde, omurilik tutulumu olan Glioblastoma Multiforme'un terapötik seçeneklerini analiz ediyoruz.

References

  • Lawton CD, Nagasawa DT, Yang I, Fessler RG, Smith ZA. Leptomeningeal spinal metastases from glioblastoma multiforme: treatment and management of an uncommon manifestation of disease. J Neurosurg Spine. 2012; 17(5): 438-448. DOI: 10.3171/2012.7.SPINE12212.
  • Grah JJ, Katalinic D, Stern-Padovan R, et al. Leptomeningeal and intramedullary metastases of glioblastoma multiforme in a patient reoperated during adjuvant radiochemotherapy. World J Surg Oncol. 2013; 11: 55. DOI: 10.1186/1477-7819-11-55.
  • Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009 [published correction appears in Neuro Oncol. 2013 May;15(5):646-7]. Neuro Oncol. 2012; 14 Suppl 5(Suppl 5): v1-v49. DOI: 10.1093/neuonc/nos218.
  • Rigau V, Zouaoui S, Mathieu-Daudé H, et al. French brain tumor database: 5-year histological results on 25 756 cases. Brain Pathol. 2011; 21(6): 633-644. DOI: 10.1111/j.1750-3639.2011.00491.x.
  • Kandaz M, Bahat Z, Guler CO, et al. Outcomes of Treatment for Glioblastoma Multiforme in Adult Patients: A Single Institution Experience from the Eastern Black Sea Region of Turkey. Uluslararası Hematoloji-Onkoloji Dergisi. 2018; 28(1): 30-35.
  • Cunha MLVD, Maldaun MVC. Metastasis from glioblastoma multiforme: a meta-analysis. Rev Assoc Med Bras (1992). 2019; 65(3): 424-433. DOI: 10.1590/1806-9282.65.3.424.
  • Jang C, Cho BK, Hwang SH, Shin HJ, Yoon SH. Leptomeningeal Spread at the Diagnosis of Glioblastoma Multiforme: A Case Report and Literature Review. Brain Tumor Res Treat. 2022; 10(3): 183-189. DOI: 10.14791/btrt.2022.0013.
  • Birzu C, Tran S, Bielle F, et al. Leptomeningeal Spread in Glioblastoma: Diagnostic and Therapeutic Challenges. Oncologist. 2020; 25(11): e1763-e1776. DOI: 10.1634/theoncologist.2020-0258.
  • Mandel JJ, Yust-Katz S, Cachia D, et al. Leptomeningeal dissemination in glioblastoma; an inspection of risk factors, treatment, and outcomes at a single institution. J Neurooncol. 2014; 120(3): 597-605. DOI: 10.1007/s11060-014-1592-1.
  • Zhao KH, Zhang C, Bai Y, et al. Antiglioma effects of cytarabine on leptomeningeal metastasis of high-grade glioma by targeting the PI3K/Akt/mTOR pathway. Drug Des Devel Ther. 2017; 11: 1905-1915. DOI: 10.2147/DDDT.S135711.
  • Minniti G, Niyazi M, Alongi F, Navarria P, Belka C. Current status and recent advances in reirradiation of glioblastoma. Radiat Oncol. 2021; 16(1): 36. DOI: 10.1186/s13014-021-01767-9.
  • Chinot OL, Wick W, Mason W, et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl J Med. 2014; 370(8): 709-722. DOI: 10.1056/NEJMoa1308345.
  • Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005; 352(10): 987-996. DOI: 10.1056/NEJMoa043330.
  • Choi PP, Shapera S. What's your call? Drop metastases. CMAJ. 2006; 175(5): 475-477. DOI: 10.1503/cmaj.060308.
  • Liu J, Shen L, Tang G, et al. Multiple extracranial metastases from glioblastoma multiforme: a case report and literature review. J Int Med Res. 2020; 48(6): 300060520930459. DOI: 10.1177/0300060520930459.
  • Sun Q, Xu R, Xu H, Wang G, Shen X, Jiang H. Extracranial metastases of high-grade glioma: the clinical characteristics and mechanism. World J Surg Oncol. 2017; 15(1): 181. DOI: 10.1186/s12957-017-1249-6.
  • Bae JS, Yang SH, Yoon WS, Kang SG, Hong YK, Jeun SS. The clinical features of spinal leptomeningeal dissemination from malignant gliomas. J Korean Neurosurg Soc. 2011; 49(6): 334-338. DOI: 10.3340/jkns.2011.49.6.334.
  • Autran D, Barrie M, Matta M, et al. Leptomeningeal Gliomatosis: A Single Institution Study of 31 Patients. Anticancer Res. 2019; 39(2): 1035-1041. DOI: 10.21873/anticanres.13210.
  • Vertosick FT Jr, Selker RG. Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery. 1990; 27(4): 516-522. DOI: 10.1097/00006123-199010000-00002.
  • Hersh AM, Lubelski D, Theodore N. Management of Glioblastoma Metastatic to the Vertebral Spine. World Neurosurg. 2022; 161: 52-53. DOI: 10.1016/j.wneu.2022.01.074.
  • Birbilis TA, Matis GK, Eleftheriadis SG, Theodoropoulou EN, Sivridis E. Spinal metastasis of glioblastoma multiforme: an uncommon suspect?. Spine (Phila Pa 1976). 2010; 35(7): E264-E269. DOI: 10.1097/BRS.0b013e3181c11748.
  • Shahideh M, Fallah A, Munoz DG, Loch Macdonald R. Systematic review of primary intracranial glioblastoma multiforme with symptomatic spinal metastases, with two illustrative patients. J Clin Neurosci. 2012; 19(8): 1080-1086. DOI: 10.1016/j.jocn.2011.09.024.
  • Coşar M, Bıkmaz K, İplikcioğlu AK, Başocak K, Ceylan D. İntrakranyal Glioblastoma Multiforme’nin Spinal Seeding şeklinde Metastazı: Olgu Sunumu. Türk Nöroşirürji Dergisi. 2004; 14(2): 111-115.
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Mustafa Kandaz 0000-0003-1106-6227

Abdulhalık Gümrükçüoğlu 0000-0001-9546-9781

İlker Eyüboğlu 0000-0002-7732-1289

Early Pub Date August 12, 2023
Publication Date September 30, 2023
Submission Date January 11, 2023
Published in Issue Year 2023 Volume: 2 Issue: 3

Cite

AMA Kandaz M, Gümrükçüoğlu A, Eyüboğlu İ. Spinal Cord Involvement of Glioblastoma Multiforme in an Adult Patient: A Case Report. Farabi Med J. September 2023;2(3):24-27. doi:10.59518/farabimedj.1232513

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