Late spinal metastasis of glioblastoma multiforme after maximal tumor resection: A case report.

Background: Glioblastoma multiforme (GBM) is the most catastrophic primary central nervous system malignancy. Extraneural metastases are rare in clinical practice and are seldom reported in the literature.

Case description: A 29-year-old Javanese male was diagnosed with GBM. Following gross total tumor resection, he underwent a full course of adjuvant radiotherapy and chemotherapy. The posttreatment period was initially uneventful, with no apparent adverse effects. However, 4 months after completion of therapy, the patient experienced a sudden onset of progressive quadriparesis, accompanied by urinary and bowel dysfunction. Contrast-enhanced cranial magnetic resonance imaging (MRI) revealed no evidence of tumor recurrence. Subsequently, a contrast-enhanced spinal MRI demonstrated extensive intradural extramedullary metastases spanning from the cervical to the lumbar spinal segments. Histopathological analysis of a biopsy specimen confirmed the spinal lesions as metastatic GBM. Given the extent of disease and associated risks, the patient and his family declined invasive therapeutic interventions. Supportive and palliative measures were provided, and the patient ultimately succumbed to respiratory failure shortly thereafter.

Conclusion: Metastasis of GBM is an uncommon clinical occurrence. Given the increased likelihood of drop metastasis following surgical intervention, it is essential for neurosurgeons and neurologists to closely monitor patients pre and postoperatively. Early detection of spinal involvement can guide timely decision-making and improve supportive care strategies.