Liang XY, Chen YP, Li Q, Zhou ZW. Atypical imaging features of the primary spinal cord glioblastoma: A case report. World J Clin Cases 2022; 10(22): 7950-7959 [PMID: 36158493 DOI: 10.12998/wjcc.v10.i22.7950]
Corresponding Author of This Article
Ze-Wang Zhou, MM, Doctor, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 12 Airport Road, Guangzhou 510405, Guangdong Province, China. zhouzewang666@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xin-Yu Liang, Ze-Wang Zhou, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Yao-Ping Chen, Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Qiao Li, Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Author contributions: Liang XY contributed to literature retrieval and screening, data reduction, and drafting of the manuscript; Chen YP contributed to literature retrieval and screening, and data analysis; Li Q contributed to acquisition of data and images, and data analysis; Zhou ZW contributed to study design and revising the manuscript critically for important intellectual content.
Supported bythe “Excellent Doctoral Dissertation Incubation Grant of First Clinical School of Guangzhou University of Chinese Medicine”, No. YB201903.
Informed consent statement: The obtained informed consent is presented in the supplementary materials for the case report to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Corresponding author: Ze-Wang Zhou, MM, Doctor, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 12 Airport Road, Guangzhou 510405, Guangdong Province, China. zhouzewang666@163.com
Received: December 13, 2021 Peer-review started: December 13, 2021 First decision: April 8, 2022 Revised: April 29, 2022 Accepted: June 23, 2022 Article in press: June 23, 2022 Published online: August 6, 2022 Processing time: 221 Days and 3.1 Hours
Abstract
BACKGROUND
Primary spinal cord (PSC) glioblastoma (GB) is an extremely rare but fatal primary tumor of the central nervous system and associated with a poor prognosis. While typical tumor imaging features are generally easy to recognize, glioblastoma multiforme can have a wide range of imaging findings. Atypical GB is often misdiagnosed, which usually delays the optimal time for treatment. In this article, we discuss a clinical case of pathologically confirmed PSC GB under the guise of benign tumor imaging findings, as well as the most recent literature pertaining to PSC GB.
CASE SUMMARY
A 70-year-old female complained of limb weakness lasting more than 20 d. Irregular masses were observed inside and outside the left foramina of the spinal canal at C7-T1 on medical imaging. Based on the imaging features, radiologists diagnosed the patient with schwannoma. Tumor resection was performed under general anesthesia. The final histopathological findings revealed a final diagnosis of PSC GB, world health organization Grade IV. The patient subsequently underwent a 4-wk course of radiotherapy (60 Gy in 20 fractions) combined with temozolomide chemotherapy. The patient was alive at the time of submission of this manuscript.
CONCLUSION
Atypical GB presented unusual imaging findings, which led to misdiagnosis. Therefore, a complete recognition of imaging signs may facilitate early accurate diagnosis.
Core Tip: This is the first literature review to summarize the imaging features of surgical and pathologically confirmed glioblastoma in the spinal cord. Lesions reported in previous cases were located in the spinal canal exclusively. Intramedullary glioma that extended beyond the spinal canal has not been reported before. In this case, the tumor grew across and beyond the spinal canal and appeared benign, which led to the misdiagnosis of neurogenic tumors. A definitive diagnosis requires histopathological confirmation. However, complete recognition of the imaging signs of the disease may facilitate early accurate diagnosis.
