Malignant glioma of the cerebrum presenting with a lumbar radiculopathy believed due to cerebrospinal fluid (CSF) spread

ABSTRACT

The case of a male aged 21 years is being presented. He first sought medical attention for pain in the left thigh found on the basis of neurological assessment to be the result of an L3 radiculopathy. Two lumbar computed tomography (CT) scans were negative. He went on to develop headaches which progressively worsened ultimately resulting in his admission to hospital when a CT scan and a subsequently magnetic resonance imaging scan showed the presence of deep right parietal and posterior thalamic tumour, which on stereotactic biopsy was consistent with an astrocytoma grade IV by the Daumas-Duport system. Subsequent repeat investigations and CSF analysis obtained at ventricular peritoneal shunting confirmed the presence of malignant cells of a glial nature in the spinal fluid. It is therefore believed that there was spread to the lumbar subarachnoid space particularly involving the L3 nerve root, resulting in his radiculopathy. A brief review of the literature concerning CSF spread of malignant gliomas will be presented.(AU)