Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up

被引:2
作者
Jumah, Fareed [1 ]
Abou-Al-Shaar, Hussam [2 ]
Mallela, Arka N. [2 ]
Wiley, Clayton A. [3 ]
Lunsford, L. Dade [2 ]
机构
[1] Rutgers New Jersey Med Sch, Rutgers Robert Wood Johnson Med Sch & Univ Hosp, Dept Neurosurg, New Brunswick, NJ USA
[2] Univ Pittsburgh, Med Ctr, Dept Pathol, Dept Neurol Surg, Pittsburgh, PA 15260 USA
[3] Univ Pittsburgh, Med Ctr, Dept Pathol, Div Neuropathol, Pittsburgh, PA USA
关键词
Follow-up; Hypothalamus; Optic pathway; Glioma; Gamma knife radiosurgery; FRACTIONATED STEREOTACTIC RADIOTHERAPY; LOW-GRADE GLIOMAS; OPTIC-NERVE; RADIATION-THERAPY; SPONTANEOUS REGRESSION; RADIOGRAPHIC RESPONSE; CHILDREN; CHILDHOOD; CHIASM; TUMORS;
D O I
10.1159/000521732
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Optic pathway/hypothalamic gliomas are rare pediatric brain tumors. The management paradigm for these challenging tumors includes chemotherapy, radiotherapy, or surgical resection, but the optimal management strategy remains elusive. Gamma knife radiosurgery (GKRS) has emerged as a promising treatment for such lesions as documented by a small number of cases in the literature. Case Presentation: We present a rare case of hypothalamic glioma in a 13-year-old girl who was referred to our service due to growth of an incidentally diagnosed hypothalamic lesion following head injury at the age of 8 years. The lesion demonstrated hypointensity on T1- and hyperintensity on T2-weighted imaging without contrast enhancement. Given the growth of the lesion on serial imaging, a stereotactic biopsy was performed demonstrating low-grade glioma. The patient underwent GKRS treatment with a marginal dose of 15 Gy at 50% isodose line for a tumor volume of 2.2 mL. Annual radiological surveillance over the next 17 years demonstrated a gradual shrinkage of the lesion until it completely disappeared. The patient is currently a healthy 31-year-old female without any visual, endocrine, or neurocognitive deficits. Conclusion: The outcome obtained after extended follow-up in our patient highlights the safety and efficacy of GKRS in the management of hypothalamic gliomas in pediatrics, which in turn can avoid potentially serious complications of surgery in this vulnerable patient population, especially in this sensitive location.
引用
收藏
页码:118 / 126
页数:9
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