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Glioblastoma of the Conus Medullaris Following Treatment of Hodgkin's Lymphoma: History of a Case and Literature Review

Pichon B, Champiat S, Aumont M, Loussouarn D, Frénel JS, Mahé MA and Demoor-Goldschmidt C

Purpose: Reports of a glioblastoma arising in a previously irradiated field are rare in the literature, even more so in the conus medullaris of the spinal cord. Method: Case report and review of the literature reporting other radiation-induced intra-medullary glioblastomas. Results: We report a case of glioblastoma of the conus, which subsequently metastasized to the brain, arising in a 45 years old man, nine years after treatment for Hodgkin's lymphoma, which had included the administration of 41 Gy to the brain and spinal cord. Conclusion: Despite a well-conducted treatment by several lines of chemotherapy, the pronostic of radiationinduced glioblastoma is poor especially since these patients often cannot benefit from a re-irradiation due to the maximum dose supported by the spinal cord. Implications of cancer survivors: Associations are now established between therapeutic exposures and specific complications but considerable inter-individual variability is observed for a given therapeutic exposure. In this context, identification of genetic susceptibilities for specific treatment-associated late effect is a very promising future approach. Improvement in our knowledge on genetic susceptibilities may help define more personalized primary therapies that weigh treatment efficacy with the risk of late complications.