6th Edition of Neurology World Conference 2026

Abstract

Primary spinal glioblastoma multiforme is a sporadic malignant tumor, more so in the pediatric population. Seeding of an intracranial GBM along the spine occurs in 25% of cases, but the reverse process (metastatic intracranial GBM disseminating from a primary intramedullary spinal GBM) is extremely rare. This is a case of a 17-year-old male with a one-month history of progressive weakness and numbness of the bilateral lower extremities, eventually affecting both bowel and bladder control. Neurologic examination showed last sensory level intact at T4 dermatome with no sacral sparing, spastic and hypperreflexive bilateral lower extremities with paraparesis, negative bulbocavernosus reflex and lax anal sphincter tone. Spinal MRI with contrast showed a lobulated expansile T1 and T2 iso to hypointense intramedullary lesion with mild heterogenous enhancement extending from T2 to T6. T3 to T6 laminectomy, laminoplasty and excision of intramedullary tumor were done. Histopathology and Immunochemistry results were consistent with Glioblastoma multiforme. He completed 28 fractions of radiotherapy (total of 5040cgy). He had intracranial leptomeningeal metastasis on the 20^th month post-operatively. He was started on temozolomide but expired on the 23^rd month post-operatively. Due to the rarity of cases, studies on the different therapeutic options are still insufficient. Hence, it remains to have an aggressive course and a poor prognosis despite available management. As recent genetic studies show the difference between pediatric spinal GBM and adult GBM, more studies focusing on the genetic basis of therapeutic options are needed to achieve better outcomes.