• Bedjan Behmanesh, Matthias Setzer, Juergen Konczalla, Patrick Harter, Johanna Quick-Weller, Lioba Imoehl, Kea Franz, Florian Gessler, Volker Seifert, and Gerhard Marquardt.
• Department of Neurosurgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany. Electronic address: bedjan.behmanesh@gmail.com.
• World Neurosurg. 2017 Feb 1; 98: 198-202.

BackgroundPrimary intramedullary spinal cord glioblastomas are very rare tumors of the spinal cord. They imply a very poor prognosis because complete surgical resection is not possible as the result of the infiltrative growth of these tumors. The aim of this study is to present our data achieved with an aggressive multimodality treatment.MethodsWe retrospectively reviewed our clinical database. All patients with histologically proven intramedullary spinal cord glioblastoma treated in our department were included in this study.ResultsFour patients with intramedullary spinal cord glioblastoma were identified between 2006 and 2015, all of whom were female. Mean age at the time of surgery was 33.5 years (range 14-50 years). Tumors were located in the cervical region in 2 patients and in the thoracic region in 2 patients. All 4 patients underwent microsurgical biopsy of the tumor. After surgery, all patients received radiation and temozolomide treatment. One patient underwent additional therapy with Bevacizumab, another patient received Rapamycin and Sunitinib, and the third patient received Chlorethyl-cyclohexyl-nitroso-urea and Etoposide as additional therapy after tumor regrowth. Tumor progression occurred in a mean time of 18.2 months (6-32 months). In this series, all patients died as the result of progression of the malignancy; median survival after diagnosis was 32.5 months.ConclusionsThe surgical outcome of intramedullary spinal cord glioblastoma still remains poor. Severe disability and amelioration of the neurologic status lead to reduced quality of life; however, an aggressive multimodal and interdisciplinary treatment for the disease may be associated with longer survival.Copyright © 2016 Elsevier Inc. All rights reserved.

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