Abstract
A 28-year-old female, who had previous stereotactic biopsy for cerebral glioma 1 month ago, presented with generalized tonic-clonic seizures. She was treated with upfront (primary); Linac-based SRS for left, temporal astrocytoma (WHO Grade II). The target volume of 4.2 cc received a marginal dose of 14.0 Gy normalized to 75% isodose line. Initial follow-up MRI showed a mild increase in tumor size (pseudo-progression) and mild peritumoral high signal in T2 study, denoting vasogenic edema. Then subsequent serial post-SRS follow-up MRIs showed progressive tumor shrinkage and markedly decreased peritumoral edema. At last clinical follow-up (200 months post-SRS), the patient had uncontrolled seizures with multiple medications, despite successful local tumor growth control. The patient was advised to undergo an epilepsy surgery.
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Further Reading
Abdelaziz OS. Radiosurgery in neurosurgical practice III: stereotactic radiosurgery for glial brain tumors. Neurosurg Q. 2000;10(2):126–30. https://www.researchgate.net/publication/286618856.
Gagliardi F, Bailo M, Spina A, et al. Gamma knife radiosurgery for low-grade gliomas: clinical results at long-term follow-up of tumor control and patients’ quality of life. World Neurosurg. 2017;101:540–53.
Niranjan A, Faramand A, Lunsford LD. Stereotactic radiosurgery for low-grade gliomas. Prog Neurol Surg. 2019;34:184–90.
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Abdelaziz, O.S., De Salles, A.A.F. (2023). Astrocytoma (WHO Grade II). In: NeuroRadiosurgery: Case Review Atlas. Springer, Cham. https://doi.org/10.1007/978-3-031-16199-5_46
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DOI: https://doi.org/10.1007/978-3-031-16199-5_46
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