DEPARTMENT OF RADIATION-INDUCED GLIOMA OF THE SPINAL-CORD

We report a case of a radiation-induced spinal cord glioma. A 20-year- old girl presented with neck pain and new significant neurological def icits 17 years after resection of a posterior fossa medullomyoblastoma and subsequent craniospinal irradiation, She was found to have a cerv ical intramedullary tumor that was resected using a standard microsurg ical technique. The permanent histopathological diagnosis was anaplast ic astrocytoma, Her neurological status was worse immediately followin g the operation. She improved to her preoperative status, but then had a relentless neurological decline resulting in death 16 weeks followi ng surgery, Because of the high incidence of malignancy in the few rad iation-induced spinal cord gliomas reported in the literature, and the poor outcome independent of therapy in patients with malignant spinal cord gliomas, an initial strategy of biopsy only may be more appropri ate than attempted resection for the patient with a suspected radiatio n-induced intramedullary spinal cord tumor.