Marked functional improvement after combined chemoradiotherapy for cervical spine glioblastoma causing quadriparesis in an adolescent.

Abstract

Primary spinal glioblastoma (GBM) is a rare spinal tumour and is considered to have poor prognosis. We describe a case of a 17-year-old adolescent boy with a cervical spine GBM presenting with neck pain and right upper limb weakness. Initial spinal MRI demonstrated a 4.5 cm lesion extending from C2 to C5 suspicious for demyelination. Despite high-dose corticosteroids, his weakness progressed resulting in quadriparesis. Subsequent laminectomy and biopsy confirmed spinal GBM. Shortly after surgery the patient continued to deteriorate and was essentially bedbound. Standard chemoradiotherapy as per the Stupp protocol, together with multimodal rehabilitation, resulted in substantial functional improvement within 6 weeks of initiation. Continued functional improvement was observed for a period of 11 months. Although an Eastern Cooperative Oncology Group (ECOG) performance score of 4 would normally preclude chemoradiotherapy, a prolonged response to treatment and return to independent function were observed.

• Authors: Peter Kar Han Lau, Gabriel Lee, Michael Bynevelt, Anna K Nowak
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (Feb 11 2014) ISSN: 1757-790X [Electronic] England
• PMID: 24518393 (Publication Type: Case Reports, Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents, Alkylating
• Bevacizumab
• Dacarbazine
• Temozolomide

Topics

• Adolescent
• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antineoplastic Agents, Alkylating (therapeutic use)
• Bevacizumab
• Cervical Vertebrae
• Chemoradiotherapy (methods)
• Dacarbazine (analogs & derivatives, therapeutic use)
• Glioblastoma (complications, pathology, therapy)
• Humans
• Magnetic Resonance Imaging
• Male
• Quadriplegia (etiology)
• Spinal Cord Neoplasms (complications, pathology, therapy)
• Temozolomide
• Treatment Outcome