Glioblastoma Spinal Cord Metastasis With Short-Term Clinical Improvement After Radiation

There is one report of slight clinically improvement with radiotherapy in which the patient’s leg strength improved from MRC 1/5 to MRC 2/5.5 Most reported cases describe no improvement with radiotherapy.4,5 The patient showed improvement clinically in the short term following radiotherapy without any change in the MRI scan. Gliosarcomas are more likely to have extracranial spread, often by way of local invasion.11 Glioblastoma with primitive neuroectodermal tumor components has a tendency to metastasize.9 Epithelioid glioblastoma tends to spread to the leptomeninges.12,13 Our patient did not have any of these imaging or histological features, thus clinicians should be prepared to diagnose spinal cord metastasis in any patient with glioblastoma. Hamilton et al. described a patient who developed spinal intramedullary spread of his supratentorial glioblastoma.6 He had surgery to establish a diagnosis, and while there was no evidence of leptomeningeal dissemination on imaging or biopsy, there were microscopic arachnoid deposits of tumor. [...]spinal intramedullary disease likely comes from direct microscopic spread of subarachnoid metastasis. Treatment decisions should be individualized based on each patient’s performance status, desire for treatment, and goals of care.