Symptomatic spinal cord metastasis from cerebral oligodendroglioma

• Published in: Neurological sciences Vol. 33; no. 3; pp. 609 - 613
• Main Authors: Elefante, A., Peca, C., Del Basso De Caro, M. L., Russo, C., Formicola, F., Mariniello, G., Brunetti, A., Maiuri, F.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-06-2012; Springer Nature B.V
• Subjects: Adult; Bone surgery; Brain; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Case Report; Cerebral Cortex - pathology; Humans; Leg; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Meninges; Metastases; Neurology; Neuroradiology; Neurosciences; Neurosurgery; oligodendroglioma; Oligodendroglioma - pathology; Oligodendroglioma - surgery; Pain; Paresis; Psychiatry; Seeding; Spinal cord; Spinal Cord Neoplasms - secondary; Spinal Cord Neoplasms - surgery; Spine; Surgery; Survival; Tumors; Brain glioma; Spinal metastasis; Cerebrospinal fluid spread; Oligodendroglioma
• ISSN: 1590-1874; 1590-3478
• DOI: 10.1007/s10072-011-0769-z

Spinal subarachnoid spread is not uncommon in brain oligodendrogliomas; on the other hand, symptomatic involvement of the spinal cord and cauda is very rare, with only 16 reported cases. We report the case of a 41-year-old man who underwent resection of a low-grade frontal oligodendroglioma 4 years previously. He was again observed because of bilateral sciatic pain followed by left leg paresis. A spine MRI showed an intramedullary T12–L1 tumor with root enhancement. At operation, an intramedullary anaplastic oligodendroglioma with left exophytic component was found and partially resected. Two weeks later, a large left frontoparietal anaplastic oligodendroglioma was diagnosed and completely resected. The patient was neurologically stable for 8 months and died 1 year after the spinal surgery because of diffuse brain and spinal leptomeningeal spread. The review of the reported cases shows that spinal symptomatic metastases can occur in both low-grade and anaplastic oligodendrogliomas, even many years after surgery of the primary tumor; however, they exceptionally occur as first clinical manifestation or as anaplastic progression. The spinal seeding represents a negative event leading to a short survival.