Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press20110.17650/2222-1468-2016-6-1-68-70CLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙEnlarged piloid astrocytoma of the midbrain: recurrence or pseudoprogression? A clinical caseУвеличение объема пилоидной астроцитомы среднего мозга: рецидив или псевдопрогрессия? Клиническое наблюдениеTruninYu. Yu.ТрунинЮ. Ю.
Russian Federation
ytrunin@nsi.ruGolanovA. V.ГолановА. В.
Russian Federation
KostyuchenkoV. V.КостюченкоВ. В.
Russian Federation
GalkinM. V.ГалкинМ. В.
Russian Federation
KhukhlaevaE. A.ХухлаеваЕ. А.
Russian Federation
KonovalovA. N.КоноваловА. Н.
Russian Federation
Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of RussiaФГБУ «Научно-исследовательский институт нейрохирургии им. акад. Н.Н. Бурденко» Минздрава России16 4th Tverskaya-Yamskaya St., Moscow, 125047, RussiaРоссия, 125047, Москва, 4-я Тверская-Ямская ул., 16300320166168703003201630032016Copyright ©; 2016, Trunin Y.Y., Golanov A.V., Kostyuchenko V.V., Galkin M.V., Khukhlaeva E.A., Konovalov A.N.Copyright ©; 2016, Трунин Ю.Ю., Голанов А.В., Костюченко В.В., Галкин М.В., Хухлаева Е.А., Коновалов А.Н.2016Trunin Y.Y., Golanov A.V., Kostyuchenko V.V., Galkin M.V., Khukhlaeva E.A., Konovalov A.N.Трунин Ю.Ю., Голанов А.В., Костюченко В.В., Галкин М.В., Хухлаева Е.А., Коновалов А.Н.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/201

Piloid astrocytoma (PA) is a glioma that is most frequently encountered in children (WHO grade I). According to most authors, stereotactic radiation (radiotherapy and radiosurgery) is an effective method to control tumor growth in patients with incomplete removal of PA and its recurrence. The authors describe a clinical case of a female patient with PA of the midbrain; during the first 7 months after radiation she showed an obvious enlargement of the tumor, as evidenced by magnetic resonance imaging (MRI), with its further regression without any antitumor treatment. A follow-up of the patient and a regular evaluation of her clinical status and MRI changes, as compared to the similar clinical cases and literature data, may suggest that PA enlargement early after radiotherapy is generally pseudoprogression rather than true progression of the tumor. An understanding of this phenomenon will be able to improve the assessment of radiotherapy results in patients with PA and to rule out unnecessary antitumor treatment in this category of patients. 

piloid astrocytomaradiosurgerystereotactic radiotherapyprogressionpseudoprogressionпилоидная астроцитомарадиохирургиястереотаксическая радиотерапияпрогрессияпсевдопрогрессия1. Douw L., Klein M., Fagel S.S. et al. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 2009;8(9):810–8.Douw L., Klein M., Fagel S.S. et al. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 2009;8(9):810–8.2. Fernandez C., Figarella-Branger D., Girard N. et al. Pilocytic astrocytomas in children: prognostic factors – a retrospective study of 80 cases. Neurosurgery 2003;53(3):544–53;discussion 554–5.Fernandez C., Figarella-Branger D., Girard N. et al. Pilocytic astrocytomas in children: prognostic factors – a retrospective study of 80 cases. Neurosurgery 2003;53(3):544–53;discussion 554–5.3. Simonova G., Novotny J. Jr, Liscak R. Lowgrade gliomas treated by fractionated gamma knife surgery. J Neurosurg 2005;102 Suppl: 19–24.Simonova G., Novotny J. Jr, Liscak R. Lowgrade gliomas treated by fractionated gamma knife surgery. J Neurosurg 2005;102 Suppl: 19–24.4. Trunin Y., Golanov A., Konovalov A. et al. Stereotactic radiation therapy and radiosurgery for brain pilocytic astrocytomas. J Radiosurg SBRT 2013; 2 Suppl 2.1:34.Trunin Y., Golanov A., Konovalov A. et al. Stereotactic radiation therapy and radiosurgery for brain pilocytic astrocytomas. J Radiosurg SBRT 2013; 2 Suppl 2.1:34.5. Naftel R.P., Pollack I.F., Zuccoli G. et al. Pseudoprogression of low-grade gliomas after radiotherapy. Pediatr Blood Cancer 2015;62(1):35–9.Naftel R.P., Pollack I.F., Zuccoli G. et al. Pseudoprogression of low-grade gliomas after radiotherapy. Pediatr Blood Cancer 2015;62(1):35–9.6. Parvez K., Parvez A., Zadeh G. The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence. Int J Mol Sci 2014;15(7):11832–46.Parvez K., Parvez A., Zadeh G. The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence. Int J Mol Sci 2014;15(7):11832–46.