Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7950
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
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.
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.
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.