The Characteristics,Diagnosis And Treatment Of Spinal Cord Glioblastoma

OBJECTIVE:By reviewing the characteristics of the spinal cord glioblastoma,including its clinical,imaging,pathology,diagnosis and treatment characteristics,this article aims to improve the u.nderstanding of this rare disease.METHODS:Five cases of spinal cord glioblastoma(M = 2,F = 3)collected from Second Affiliated Hospital of Zhejiang University from April 2012 to May 2016,were observed for their its clinical,imaging,pathology,diagnosis and treatment characteristics.Literatures were reviewed to summarize the differential diagnosis and treatment choice about spinal cord glioblastoma.RESULTS:The five patients,including two males and three females,were at an average age of 41.2 years,of which the disease course was from 11 days to 3years.And two of the cases were died,the overall survival time was respectively 208 days and 330 days.They had different symptoms,characterized by decreased muscle strength,paresthesia,progressive paralysis and sphincter disturbances.The Magnetic resonance Imaging(MRI)is not unique;they often demonstrate equal or slightly lower T1 signal,with heterogeneous contrast enhancement;T2 is characterized by high signal.All the five patients have had Molecular Pathological detection;all of them are IDH1 wild type(5/5),1 case positive for PTEN(1/5),3 cases of P53 expression in patients with increased(3/5),2 cases of patients with EGFR positive(2/5),3 patients occurred MGMT methylation(3/5).The treatment was tumor resection followed by radiotherapy and chemotherapy.CONCLUTION:1.Spinal cord glioblastoma should surgery as soon as possible when it was diognosed.Under the auxiliary of sodium fluorescein and neural electrophysiological monitoring technology,it will be safer to resect the tumor as far as possible,so as to relieve symptoms and improve the postoperative quality of life.2.There is no obvious specificity about spinal cord glioblastoma on imaging,but MRI examination is helpful to clear the area of tumorigenesis,involving the scope,the presence of necrosis,as well,it holds significant value to the post-operative long-term follow-up.3.The molecular examination of spinal cord glioblastoma helps to determine the tumor grade and its invasiveness.