Objectives: The effects of brain tumors located in the supplementary motor area (SMA) have so far been described mainly in the context of motor and speech disorders. There are few studies that have considered other cognitive domains, so this study aimed to fill this gap by focusing on examining attention and working memory in a population of patients with gliomas in the SMA region. Methods: This study included 50 patients diagnosed with gliomas located in the SMA who have not yet had any treatment and 57 demographically matched healthy individuals. A set of neuropsychological tests was conducted to assess attention and working memory: Digit Span from WAIS-R, Visual Elevator from TEA, Verbal Fluency Test (switching condition), and Color Trails Test (CTT). Results: The analyses showed that patients scored lower in most of the evaluated tests and indicators, namely in Digit Span-forward (t = −2.05; p = 0.022), Digit Span-backward (t = −2.63; p = 0.005), CTT-2 (t = 4.24; p = 0.001), CTT-interference (t = 2.31; p = 0.012), Visual Elevator-time (t = 1.83; p = 0.035), Visual Elevator-accuracy (t = −2.42, p = 0.010), and Verbal Fluency-switching (t = −3.41; p = 0.001). A significant relationship was also demonstrated between the grade of tumor malignancy and the results achieved in some of the neuropsychological tests. The lateralization of the tumor, the size of the lesion, and the presence of epilepsy did not prove to be particularly significant. Conclusions: Due to the significant decline in cognitive performance in terms of attention and working memory, we believe that every patient with a tumor in the SMA should undergo a detailed neuropsychological examination, which will profile their functioning and help tailor the best possible psychological care.

Introduction: Intramedullary glioblastoma is a rare entity comprising 1.4–9% of spinal gliomas. Spinal cord radiation-induced gliomas are unique, with only 13 cases reported to date. Case Presentation: A 53-year-old female with a history of mediastinal Hodgkin lymphoma treated with chemotherapy and radiotherapy who subsequently developed thyroid cancer and breast cancer throughout her life was admitted due to slowly progressing spastic tetraparesis. Cervical MRI revealed an intramedullary lesion at the C4–T1 level, enlarging the spinal cord, with a heterogenous contrast enhancement and a lesion within T1 vertebral body showing contrast enhancement. Whole-body 18F-FDG-PET/CT revealed increased radionuclide uptake within the cervical spinal cord at the C2–C7 level and a focus of increased metabolic activity within the T1 vertebral body. The patient underwent a C4–T2 laminectomy with tumor debulking, and a biopsy of the T1 vertebral body was taken. Closure was performed with thecal sac expansion using a fascia lata graft and open-door laminoplasty. The histomolecular results confirmed the diagnosis of glioblastoma, IDH-wildtype (CNS WHO G4), in the cervical spinal cord lesion and breast cancer metastasis in the T1 vertebral body. Postoperatively, the patient experienced progression of lower extremities and left arm paresis. No adjuvant therapy was administered due to neurological deficit progression. The patient died 6 months after surgery. Conclusion: We report a case of an intramedullary glioblastoma in a patient with a history of radiation and multiple neoplasms located at the irradiation field borders. The full molecular analysis allowed for classification of the tumor as glioblastoma, IDH-wildtype (CNS WHO G4), and screening for germinal mutations potentially predisposing to spontaneous neoplasm development.