P22 A RETROSPECTIVE REVIEW OF GRADE 3 SUPRATENTORIAL GLIOMAS WITH SPINAL METASTATIC RELAPSE

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2014-10, Vol.16 (suppl 6), p.vi4-vi5
• Main Authors: Gilani, S., Giridharan, S.
• Format: Article
• Language: English
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nou249.20

INTRODUCTION: Grade 3 gliomas rarely metastasize. Originally Macdonald et al describe two patterns of spread; one via lymphatics to scalp due to multiple craniotomies and the other to bone marrow via blood stream. Occasionally tumour can also spread via Cerebrospinal Fluid (CSF) spinal cord. This occurs due to transfer of tumour cells to CSF through ependymal or pia matter. Symptomatic spinal spread is so rare in grade 3 gliomas, only 16 cases have been reported so far. We describe two such patients in our practice who developed symptomatic spinal metastasis. METHOD: We retrospectively reviewed cohort of grade 3 gliomas that were treated in our Centre from 2007 to 2013. Electronic and paper records were used to examine diagnoses,treatments,relapse pattern,symptoms and outcomes,particularly looking at leptomeningeal relapse in grade 3 tumours. RESULTS: A total of 16 grade 3 gliomas were treated during this period. We describe 2 cases of histologically confirmed oligodendroglial tumours found in this cohort who developed symptomatic leptomeningeal/spinal relapse during their course of illness. These patients initially underwent craniotomy and debulking surgery. Average time from diagnosis of the primary intracranial tumour to diagnosis of CSF dissemination ranged from 2 to 5 years. Survival from diagnoses of leptomeningeal relapse ranged from 4 to 8 weeks. CONCLUSION: Symptomatic dissemination through CSF of grade 3 supratentorial glial tumours is rare, but recognized pattern of relapse. It is important to recognize & suspect it when patient presents with symptoms of spinal cord compression. By sharing these reports, authors recommend a high index of suspicion is maintained when encountered with extracnial signs & symptoms.