Yetişkin Bir Hastada Glioblastoma Multiforme’nin Spinal Kord Tutulumu: Bir Olgu Sunumu
Glioblastoma Multiforme, merkezi sinir sisteminin agresif progresyon gösteren ve çoğunlukla erişkinlerde görülen primer malign neoplazmıdır. Literatür, Glioblastoma Multiforme tedavisini cerrahi, eş zamanlı kemo-radyoterapi ve adjuvan kemoterapinin kombine süreci olarak kabul etmektedir. Glioblastoma Multiforme çeşitli yollarla yayılabilir. Beyaz cevher yolları kullanılarak intraparenkimal yayılım en bilinen yayılma şeklidir. Glioblastoma Multiforme'un beyin omurilik sıvısı yoluyla yayılması, damla metastazlarına, leptomeningeal yayılmaya ve spinal metastaza neden olabilir. Glioblastoma Multiforme hastalarında leptomeningeal yayılım için tedavi rehberi hiç hazırlanmamıştır. Bununla birlikte, tümörün cerrahi olarak çıkarılması, Glioblastoma Multiforme'un kabul edilen tedavisidir. Soliter metastazı olan omurilik basısı olan hastalarda cerrahi tedavi önemli bir seçenektir. Ancak yaygın spinal kanal tutulumu ve spinal kord basısı olan hastaların tedavisinde palyatif radyoterapi ve kemoterapi kullanılabilir. Erişkin bir hastada Glioblastoma Multiforme tedavisi sonrası gelişen omurilik metastazı nedeniyle radyoterapi uyguladığımız bir olguyu sunuyoruz. Bu gözlemler sayesinde, omurilik tutulumu olan Glioblastoma Multiforme'un terapötik seçeneklerini analiz ediyoruz.
Anahtar Kelimeler:
Glioblastoma Multiforme, Spinal Metastaz, Radyoterapi
Spinal Cord Involvement of Glioblastoma Multiforme in an Adult Patient: A Case Report
Glioblastoma Multiforme is a primary malignant neoplasm of the central nervous system which has aggressive progression and mostly seen in adults. Literature accepts the treatment for Glioblastoma Multiforme as combined process of surgical, concurrent chemo-radiotherapy, adjuvant chemotherapy. Glioblastoma Multiforme can spread in a variety of ways. Intraparenchymal spread by using white matter tracts is the most known way of spreading. Dissemination of Glioblastoma Multiforme through cerebrospinal fluid can happen, causing drop metastases, leptomeningeal spread and spinal metastasis. Treatment guideline for leptomeningeal spread in patients with Glioblastoma Multiforme has never been prepared. However, complete surgical removal of the tumor is the accepted treatment of Glioblastoma Multiforme. Surgical treatment is an important option in patients with spinal cord compression with solitary metastases. However, palliative radiotherapy and chemotherapy can be used in the treatment of patients with extensive spinal canal involvement and spinal cord compression. We present a case in which we applied radiotherapy because of spinal cord metastasis that developed after Glioblastoma Multiforme treatment in an adult patient. Through these observations, we analyze therapeutic options of Glioblastoma Multiforme with spinal cord involvement.
Keywords:
Glioblastoma Multiforme, Spinal Metastasis, Radiotherapy,
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- Başlangıç: 2022
- Yayıncı: Karadeniz Teknik Üniversitesi
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