Shrestha Pritee, Eineichner Tara, Wilson Brittany, Lam Naomi S
Internal Medicine, MercyOne North Iowa, Mason City, USA.
Surgery, Des Moines University, Des Moines, USA.
Cureus. 2023 Aug 16;15(8):e43580. doi: 10.7759/cureus.43580. eCollection 2023 Aug.
Primary spinal cord glioblastoma multiforme (GBM) remains uncommon and typically affects males and patients during their fifth decade of life. Our case demonstrates a 77-year-old woman who initially presented with right arm paresthesia and limited range of motion and was subsequently diagnosed with primary spinal cord GBM. Our case illustrates an atypical and nonspecific neurological presentation highlighting that spinal cord GBM can have a more indolent course, unlike what current literature suggests. It also emphasizes the importance of considering a multimodal approach when managing atypical neurological symptoms and considering an early intervention, including magnetic resonance imaging, to rule out occult neoplasm in an appropriate clinical setting, thus preventing delay in the diagnosis. This case further emphasizes the role of molecular biomarkers of tumors, including isocitrate dehydrogenase mutation as well as methylguanine-DNA methyltransferase promoter methylation status, that can independently guide and affect the treatment outcomes in this patient population.
原发性脊髓多形性胶质母细胞瘤（GBM）仍然不常见，通常影响男性以及50岁左右的患者。我们的病例是一名77岁女性，最初表现为右臂感觉异常和活动范围受限，随后被诊断为原发性脊髓GBM。我们的病例说明了一种非典型和非特异性的神经学表现，突出表明脊髓GBM的病程可能更为隐匿，这与当前文献所提示的情况不同。它还强调了在处理非典型神经症状时考虑采用多模式方法以及在适当的临床环境中考虑早期干预（包括磁共振成像）以排除隐匿性肿瘤的重要性，从而防止诊断延误。该病例进一步强调了肿瘤分子生物标志物的作用，包括异柠檬酸脱氢酶突变以及甲基鸟嘌呤 - DNA甲基转移酶启动子甲基化状态，它们可以独立指导并影响该患者群体的治疗结果。
