Primary spinal glioblastoma multiforme with diffuse cervico-thoracic level involvement

Glioblastoma multiforme (GBM) is the most common glial tumor of adulthood. Nevertheless, a primary spinal intramedullary location is very rare. An early diagnosis is important because there is rapid clinical deterioration and a mean survival of approximately one year. We discuss the clinical and radiological findings and course of a primary spinal GBM with diffuse involvement of the cervical and upper thoracic spinal cord. A 39 year-old-man presented with numbness in the hands and feet. After a laboratory work-up, he was diagnosed with type-II diabetes. Diabetic neuropathy and myelitis were considered in the differential diagnosis. However, the clinical findings progressed rapidly. Magnetic resonance imaging (MRI) of the cervical and thoracic spine showed an intramedullary lesion diffusely involving the cervical and upper thoracic level with peripheral edema. After fine needle aspiration biopsy, GBM was diagnosed. The lesion was removed subtotally at surgery. Radiotherapy was planned, but his clinical condition deteriorated rapidly and he died. He survived for about 8 months after diagnosis. The early radiological and clinical findings of primary spinal GBM can be confused with other spinal cord intramedulllary pathologies. The frequency of reported primary spinal GBM cases is increasing.