CASE STUDY

A 73-year-old patient previously diagnosed with right glioblastoma reported intensified back pains, particularly in the lumbar region. A spinal MRI was conducted to identify imaging anomalies that could explain these symptoms. The MRI revealed secondary metastases, both bone-related and extramedullary intradural, localized at the level of the spinal cord (L1-L2) and dorsal vertebrae (D9 and D11). These areas exhibited unusual signals on MRI images following gadolinium injection (Figures 1-5).

DISCUSSION

Intradural metastases constitute only a small fraction of secondary spinal localizations, typically situated outside the spinal cord. Only 3.5% are strictly intramedullary, attributed to the aggressiveness of glioblastoma within the subarachnoid spaces [3]. In contrast, intradural metastases seem to follow a different path of spread through cerebrospinal fluid (CSF). These cases remain rare, primarily due to the short lifespan associated with this type of intradural metastasis stemming from glioblastoma. Surgical removal of these spinal metastases is often decided based on patient symptoms and the lesion's location [4-5]. Unfortunately, patient survival is reduced, ranging from a few months to two years, with a discouraging prognosis.

CONCLUSION

Extracranial metastases of glioblastoma multiforme (GBM) are rare due to the short survival experienced by the patients [6]. Spinal MRI remains pivotal for diagnosis, and the recommended treatment involves surgical resection and postoperative radiotherapy, accompanied by concurrent and adjuvant temozolomide chemotherapy, remain the standard of care [5].