Leptomeningeal spread with spinal involvement of pineal glioblastoma at initial presentation: A case report

Abstract

A 51-year-old man presented with one week of acute headache, nausea, and vomiting. Brain and spine MRI showed an enhancing pineal lesion and intradural and leptomeningeal spread throughout the neuroaxis. An intradural biopsy was performed at L4–L5, and histopathology exhibited a malignant neuroepithelial tumor; molecular analysis confirmed gliobastoma WHO grade IV. The patient received craniospinal radiation and stereotactic boost to the large symptomatic pineal and spinal masses. Differential diagnosis for spinal involvement and leptomeningeal spread of pineal region tumors is wide, but we should include glioblastoma on this differential.

Keywords

• Extra-cranial
• Glioblastoma
• GBM
• Leptomeningeal disease