Spontaneous Complete Regression Of A Brain Stem Glioma Pathologically Diagnosed As A High-grade Glioma.
Ishihara, M., Yamamoto, K., Miwa, H., & Nishi, M. (2017). spontaneous complete regression of a brain stem glioma pathologically diagnosed as a high-grade glioma. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 33(12), 2177–2180. https://doi.org/10.1007/s00381-017-3570-3
View Original Source →Abstract
BACKGROUND: Spontaneous regressions of brain stem gliomas are extremely rare. Only six cases have been reported in the literature. CASE PRESENTATION: We describe the case of a patient who was diagnosed with a pontomedullary dorsal brain stem glioma at the age of 15 years. An open biopsy showed the presence of an anaplastic glioma. Because the patient and her parents refused conventional therapies, including radiation and chemotherapy, we followed up the patient by performing magnetic resonance imaging scans on her every 3 months. At 3 months after biopsy, we observed the radiological disappearance of her tumor. One year after biopsy, the tumor retained the spontaneous complete regression observed earlier. CONCLUSION: In this case report, we present the first report of the spontaneous complete regression of a brain stem glioma that was histologically proven to be a high-grade glioma and we believe that this regression was the natural progression of this case, as may be the scenario in a few other cases of brain stem gliomas.
Case Details
Disease Location
Pontomedullary dorsal brain stem glioma
Personal Characteristics
15-year-old female
Clinical Characteristics
A 15-year-old girl presented with rapidly progressing diplopia, difficulty in swallowing, and gait disturbance. Pe: paralysis of the left abudens, facial, glossopharyngeal, and vagus nerves, and a cerebellar ataxic gait. MRI of the brain revealed the presence of a large lesion involving the left dorsal side of the brain stem from the midbrain to the medulla. A partial lesion showed ring enhancement under gadolinium contrast from the left middle cerebellar peduncle to the left dorsal medulla: consistent with brainstem glioma. Neuro-navigation-assisted open biopsy confimred anaplastic astrocytoma. Infectious diseases and demyelinating diseases ruled out.
Remission Characteristics
Parents refused treatment for preference of japanese healer. 3 months post biopsy, lesion disappeared on MRI but cranial nerve palsy persisted. MRI 1 years later shows undetectable lesion.
Treatment & Mechanisms
Proposed Remission Mechanisms
Biopsy may have triggered apoptosis
Non-Clinical Treatment
Japanese healer