A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI.

Abstract

A fourteen years-old boy was treated post-operatively with proton therapy for a recurrent low-grade oligodendroglioma located in the tectal region. Six months after the end of irradiation (RT), a new enhancing lesion appeared within the radiation fields. To differentiate disease progression from radiation-induced changes, dynamic susceptibility contrast-enhanced (DSCE) MRI was used with a T2* sequence to study perfusion and permeability characteristics simultaneously. Typically, the lesion showed hypoperfusion and hyperpermeability compared to the controlateral normal brain. Without additional treatment but a short course of steroids, the image disappeared over a six months period allowing us to conclude for a pseudo-progression. The patient is alive in complete remission more than 2 years post-RT.

• Authors: Candice Meyzer, Frédéric Dhermain, Denis Ducreux, Jean-Louis Habrand, Pascale Varlet, Christian Sainte-Rose, Christelle Dufour, Jacques Grill
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 5 Pg. 9 (Feb 04 2010) ISSN: 1748-717X [Electronic] England
• PMID: 20132555 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Contrast Media
• Protons
• Prednisone

Topics

• Adolescent
• Anti-Inflammatory Agents (therapeutic use)
• Brain Neoplasms (radiotherapy)
• Child
• Contrast Media
• Glioma (radiotherapy)
• Humans
• Image Enhancement
• Magnetic Resonance Imaging (methods)
• Male
• Neoplasm Recurrence, Local (radiotherapy)
• Prednisone (therapeutic use)
• Protons (adverse effects)
• Radiation Injuries (diagnosis, drug therapy)
• Radiotherapy (adverse effects)