Abstract Details

Title High Grade Glioma of the Spinal Cord: A Cases Series of Rare Malignancy

Topic Neuro-oncology

Presentation(s) Neuro-oncology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 038

Objective To describe a single-institution experience with primary spinal cord high grade astrocytomas.

Background

Primary spinal cord astrocytomas represent a rare class of central nervous system malignancy comprising approximately 6-8% of all spinal cord tumors. The vast majority are low grade (WHO I and II), while high grade tumors (WHO III and IV) are much less common; specifically, primary spinal cord glioblastoma accounts for only 1.5% of all spinal cord tumors. Primary spinal cord astrocytomas most commonly affect the cervicothoracic segments and present in all age groups. For high grade tumors, overall survival is poor due to their aggressive nature. Furthermore, unlike their intracranial counterparts, there is not a clear consensus on the optimal treatment. Here, we present our institutional experience with three varied cases of primary spinal cord high grade astrocytoma.

Design/Methods Case series

Results Of our three patients, two had PSC GBM (WHO IV), while one had IDH-wildtype anaplastic astrocytoma (WHO III). Of the two patients with PSC GBM, one received no treatment given the extent of neurologic debilitation at the initial presentation and she died five months after diagnosis. The other patient was initially treated with surgical resection, radiation, and bevacizumab before developing intraventricular metastases 14 months after initial diagnosis; he was subsequently treated with temozolomide and bevacizumab until he suffered recurrent, progressive disease 14 months later, at which time he was treated with carboplatin and bevacizumab. However, he continued to suffer from progressive disease and died three years after the initial diagnosis. Our patient with anaplastic astrocytoma shows no evidence of disease recurrence eight months after initial diagnosis following treatment with surgical resection and adjuvant radiation/temozolomide.

Conclusions These cases demonstrate varied clinical courses of and treatment approaches for primary spinal cord high grade astrocytoma, thereby highlighting the challenges that can arise in treating these rare tumors.

Authors/Disclosures
Madison Shoaf, MD (Duke Cancer Center, Clinic 3-1) PRESENTER	Dr. Shoaf has nothing to disclose.
Katherine B. Peters, MD, PhD, FAAN (Duke University Medical Center)	Dr. Peters has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sapience. Dr. Peters has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NuVox Therapeutics. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ONO Pharmaceutical. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Telix. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AnHeart. Dr. Peters has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Rigel. The institution of Dr. Peters has received research support from Biomimetix. The institution of Dr. Peters has received research support from Servier. The institution of Dr. Peters has received research support from Varian. The institution of Dr. Peters has received research support from Sapience. The institution of Dr. Peters has received research support from Ono Pharmaceuticals.

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