Diffuse Low-Grade Glioma With Spontaneous Radiological Regression: A Case to Be Followed

Low-grade gliomas (LGGs) are slow-growing, infiltrative brain tumors with a tendency to progress over time. Spontaneous regression of LGG is an exceptionally rare phenomenon, with only one case documented in the literature. The mechanisms underlying this phenomenon remain unclear but may involve immunological responses, spontaneous apoptosis, vascular remodeling, or hormonal influences, and may open up some new therapeutic perspectives for the future. We report the case of a 21-year-old woman with no medical history who presented with headaches, visual disturbances, and progressive left-sided hemiparesis. Brain MRI revealed a diffuse glioma in the splenium of the corpus callosum, extending into the parieto-rolandic region. A stereotactic biopsy confirmed the diagnosis of a diffuse LGG (not otherwise specified (NOS)). The patient received only symptomatic treatment with anticonvulsants and five days of corticosteroids, without adjuvant therapy. At the six-month follow-up, she showed significant neurological improvement, and imaging demonstrated partial tumor regression. By the one-year follow-up, the lesion had nearly disappeared, with no signs of recurrence. A histopathological review confirmed the initial diagnosis, ruling out other possible differential diagnoses. Spontaneous regression of diffuse LGG remains an extremely rare event with unclear underlying mechanisms. This case underscores the complexity of glioma biology and highlights the need for further research to explore potential predictive biomarkers and alternative therapeutic strategies based on the pathways involved in spontaneous regression.