Glioblastoma Multiforme: A Rare Case of Spinal Drop Metastasis.

Abstract

The occurrence of spinal drop metastasis in patients diagnosed with glioblastoma multiforme (GBM) is rare. In previous reports, this diagnosis occurred after surgical resection of GBM, which was believed to increase the likelihood of tumor seeding. Diagnosis of spinal drop metastasis prior to surgery remains rare. We report a 57-year-old woman with a brief history of confusion, altered behavior, and agitation without any other significant past medical history. Computed tomography and magnetic resonance imaging (MRI) of the head demonstrated an intra-axial lesion of the right temporal lobe as well as evidence of leptomeningeal disease around the medulla. A spine MRI scan revealed spinal drop metastases at the level of C1 and T6/T7. Subsequent biopsy confirmed WHO-2016 grade IV GBM. The awareness of the possibility of spinal drop metastasis prior to surgical resection of GBM is important. The use of routine MRI of the whole neuroaxis in patients diagnosed with GBM can aid in prognosis and management options.