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Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 1209-1212

Intramedullary glioblastoma multiforme of spine with intracranial supratentorial metastasis: Progressive disease with a multifocal picture

1 Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
2 Department of Neurosurgery, Army Hospital Research and Referral, New Delhi, India
3 Department of Radiology, Army Hospital Research and Referral, New Delhi, India

Correspondence Address:
Dr. Abhishek Purkayastha
Department of Radiation Oncology, Army Hospital Research and Referral, Dhaula Kuan, Delhi Cantt, New Delhi - 110 010
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_67_17

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Primary spinal glioblastoma multiforme (GBM) is very uncommon while an intramedullary spinal GBM with intracranial metastasis is rarely heard of. A 23-year-old male presented with bilateral paraplegia associated with bowel and bladder incontinence. Craniospinal radiograph showed an intramedullary spinal mass lesion, for which he underwent laminectomy and histopathology revealed GBM. He received local radiotherapy (RT) with temozolomide (TMZ). While on adjuvant TMZ, he developed severe headache and recurrent episodes of vomiting. Brain and spine imaging showed intracranial mass lesions associated with expansion of the entire cord. Biopsy from the intracranial lesion was confirmed as GBM on immunohistopathology. He was treated with palliative RT to the brain and was put on metronomic TMZ; however, he succumbed to his illness. Review of literature reveals that our case may be the fourth such case in the world and probably the first case reported in India where the intracranial metastatic GBM again presented with a reverse spinal dissemination.

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