A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI

Radiat Oncol. 2010 Feb 4:5:9. doi: 10.1186/1748-717X-5-9.

Abstract

A fourteen years-old boy was treated post-operatively with proton therapy for a recurrent low-grade oligodendroglioma located in the tectal region. Six months after the end of irradiation (RT), a new enhancing lesion appeared within the radiation fields. To differentiate disease progression from radiation-induced changes, dynamic susceptibility contrast-enhanced (DSCE) MRI was used with a T2* sequence to study perfusion and permeability characteristics simultaneously. Typically, the lesion showed hypoperfusion and hyperpermeability compared to the controlateral normal brain. Without additional treatment but a short course of steroids, the image disappeared over a six months period allowing us to conclude for a pseudo-progression. The patient is alive in complete remission more than 2 years post-RT.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use
  • Brain Neoplasms / radiotherapy*
  • Child
  • Contrast Media
  • Glioma / radiotherapy*
  • Humans
  • Image Enhancement
  • Magnetic Resonance Imaging / methods*
  • Male
  • Neoplasm Recurrence, Local / radiotherapy*
  • Prednisone / therapeutic use
  • Protons / adverse effects
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / drug therapy
  • Radiotherapy / adverse effects

Substances

  • Anti-Inflammatory Agents
  • Contrast Media
  • Protons
  • Prednisone