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Multiple oligodendroglioma with pseudoprogression
1Department of Neurosurgery, Fujita Health University, 1-98, Dengakugakubo, Kutsukake, Aichi, Japan.
Abstract:
A 72 year-old male hospitalized with aphasia, abnormal behavior, and rapidlyprogressive dementia.Magnetic resonance imaging (MRI) enhanced by contrast media demonstrated multiplebrain tumors in left parietal lobe and left paraventricular region. Biopsy was performed,andhistopathological examination and genetical evaluation revealed anaplasticoligodendroglioma. Local radiation 50Gy was given, and Temozolomide via orallyadministered for 42 days. After the chemoradiotherapy, even though the parietal tumorshowed lessening of the size, enlargement of the tumor in the left paraventricularregion was observed, and we considered that phenomenon was pseudoprogression. 5courses of Temozolomide therapy was added, but cerebellar tumor appeared andenlarged with hydrocephalus, and died 1 year and 3 months after the firsthospitalization.
Insights
A 72-year-old male with anaplastic oligodendroglioma experienced rapid neurological decline. Despite initial treatment, tumor progression and pseudoprogression complicated management, leading to a fatal outcome.
Area of Science:
- Neuro-oncology
- Neuropathology
- Radiation Oncology
Background:
- Anaplastic oligodendroglioma is a rare brain tumor often presenting with diverse neurological symptoms.
- Early diagnosis and multimodal treatment are crucial for managing brain malignancies.
Observation:
- A 72-year-old male presented with aphasia, behavioral changes, and progressive dementia.
- MRI revealed multiple brain tumors, with biopsy confirming anaplastic oligodendroglioma.
- Initial treatment included radiation therapy and Temozolomide.
Findings:
- Post-treatment, a decrease in parietal tumor size was noted, but paraventricular tumor enlargement suggested pseudoprogression.
- Further Temozolomide cycles were administered, followed by the appearance and enlargement of a cerebellar tumor with hydrocephalus.
- The patient succumbed to the disease 1 year and 3 months after initial hospitalization.
Implications:
- This case highlights the challenges in differentiating true tumor progression from pseudoprogression in anaplastic oligodendroglioma.
- The complex clinical course underscores the aggressive nature of this tumor and the need for careful treatment monitoring.
- Understanding treatment response patterns is vital for optimizing therapeutic strategies in neuro-oncology.
