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AJNR - American Journal of Neuroradiology

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Glioblastoma Multiforme of the Conus Medullaris in a Child: Description of a Case and Literature Review

Alessandro Stecco^a, Claudia Quirico^a, Amelia Giampietro^a, Giuseppe Sessa^a, Renzo Boldorini^b,c and Alessandro Carriero^a,c

^a SCDU Radiologia, AO Maggiore della Carità, Novara, Italy
^b SCDU Anatomia Patologica , AO Maggiore della Carità, Novara, Italy
^c Dipartimento di Scienze Mediche , Università del Piemonte Orientale Novara, Italy

View larger version (162K): [in a new window]   FIG 1. A–C, Fast spin-echo T2-weighted sagittal acquisition (A) shows a hyperintense and homogeneous mass at the T12 level, involving the conus and the epicomus, with a diffuse aspect and without a clear cleavability plane. Spin-echo T1-weighted sagittal (B) and coronal (postgadolinium) (C) acquisitions show a hypointense lesion with a mild patchy nodular enhancement of the upper portion, associated with a faint enhancement along the pial surface.

View larger version (166K): [in a new window]   FIG 2. A–C, Nine-month follow-up after surgery. Fast spin-echo T2-weighted (A) and spin-echo T1-weighted (postgadolinium) (B) sagittal lumbar spine acquisitions show a local recurrence of the disease. Note the leptomeningeal spread (B, C) along the entire spinal canal, up to the posterior cerebral fossa (C).

View larger version (158K): [in a new window]   FIG 3. Photomicrograph of histologic findings shows glioblastoma multiforme. Note high cellular attenuation, pleomorphism, and mitosis of neoplastic cells (hematoxylin and eosin, original magnification x400).

View larger version (157K): [in a new window]   FIG 4. Photomicrograph of histologic findings shows anti-Ki67 (MIB-one) antiserum indicating a high-proliferating index in neoplastic cells (immunoperoxidase, hematoxylin counterstaining, original magnification x400).