Clinical and magnetic resonance imaging features of spinal cord glioblastoma multiforme in a series of 12 cases: A single-institutional experience

Background: Spinal cord glioblastoma multiforme (SCGBM) is an extremely rare malignant tumor. The study aims to present the clinical and imaging features of SCGBM. Methods: The clinical and magnetic resonance imaging (MRI) characteristics of 12 pathologically proven SCBGM patients were retrospectively analyzed. Results: Three major MRI findings are as follows: (1) Mixed hypo-isointense signal on T1-weighted image (T1WI) and hyper-isointense signal on T2WI in all cases, (2) All except two patients demonstrated slight syringomyelia at upper or lower side of the lesion, and (3) Post-gadolinium-diethylenetriamine pentaacetic acid, a heterogeneously enhanced lesion with the crab foot-like shape on the map was seen in 11/12 cases. Clinically, pain in neck and waist was reported in 7 cases (58%) and progressive weakness of both lower extremities in 6 patients (50%). Gross total resection in 3 cases (25%) and subtotal resection in 9 cases (75%) were achieved. The most common postoperative complication was spinal instability, developed in 3 patients. The progress-free survival of surgery, surgery + temozolomide (TMZ), and surgery + TMZ + radiation treated patients was 2.50, 7.75, and 12.66 months, respectively. The overall survival of surgery, surgery + TMZ, and surgery + TMZ + radiation treated patients was 5.50, 15.25, and 24.00 months, respectively. Conclusion: The study reported MRI features in a large series of SCGBM. The trimodal therapy could provide longer survival for SCGBM patients.