Enlarged piloid astrocytoma of the midbrain: recurrence or pseudoprogression? A clinical case

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Abstract

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. 

About the authors

Yu. Yu. Trunin

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Author for correspondence.
Email: ytrunin@nsi.ru
Russian Federation

A. V. Golanov

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Email: fake@neicon.ru
Russian Federation

V. V. Kostyuchenko

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Email: fake@neicon.ru
Russian Federation

M. V. Galkin

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Email: fake@neicon.ru
Russian Federation

E. A. Khukhlaeva

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Email: fake@neicon.ru
Russian Federation

A. N. Konovalov

Acad. N.N. Burdenko Neurosurgery Research Institute at the Ministry of Health of Russia; 16 4th Tverskaya-Yamskaya St., Moscow, 125047, Russia

Email: fake@neicon.ru
Russian Federation

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