Glioblastoma Multiforme in the Pineal Region with Leptomeningeal Dissemination and Lumbar Metastasis.
10.3340/jkns.2015.58.5.479
- Author:
Ryosuke MATSUDA
1
;
Yasuo HIRONAKA
;
Tadashi SUIGIMOTO
;
Hiroyuki NAKASE
Author Information
1. Department of Neurosurgery, Nara Medical University, Kashihara, Japan. cak93500@pop02.odn.ne.jp
- Publication Type:Case Report
- Keywords:
Glioblastoma multiforme;
Pineal region;
Leptomeningeal dissemination;
Spinal metastasis
- MeSH:
Adult;
Brain;
Brain Stem;
Diagnosis;
Diagnosis, Differential;
Drug Therapy;
Female;
Glioblastoma*;
Headache;
Humans;
Hydrocephalus;
Leg;
Low Back Pain;
Lumbosacral Region;
Magnetic Resonance Imaging;
Neoplasm Metastasis*;
Neoplasm, Residual;
Pinealoma;
Radiotherapy;
Vomiting
- From:Journal of Korean Neurosurgical Society
2015;58(5):479-482
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of a 31-year-old woman with glioblastoma multiforme (GBM) in the pineal region with associated leptomeningeal dissemination and lumbar metastasis. The patient presented with severe headache and vomiting. Magnetic resonance imaging (MRI) of the brain showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. After an urgent ventricular-peritoneal shunt, she was treated by subtotal resection and chemotherapy concomitant with radiotherapy. Two months after surgery, MRI showed no changes in the residual tumor but leptomeningeal dissemination surrounding the brainstem. One month later, she exhibited severe lumbago and bilateral leg pain. Thoracico-lumbar MRI showed drop like metastasis in the lumbar region. Finally she died five months after the initial diagnosis. Neurosurgeons should pay attention to GBM in the pineal region, not only as an important differential diagnosis among the pineal tumors, but due to the aggressive features of leptomeningeal dissemination and spinal metastasis.
