Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy
In brain tumor patients, worsening of imaging findings in the first 6 months after surgical debulking and chemoradiation can occur in the absence of tumor growth, a phenomenon known as pseudoprogression. Awareness of pseudoprogression is important as it can lead to unnecessary additional changes in...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-05-01
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| Series: | Radiology Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043318305600 |
| _version_ | 1828941382010535936 |
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| author | Nikhar Kinger, MD Michael J. Hoch, MD Hui-Kuo G. Shu, MD Brent D. Weinberg, MD, PhD |
| author_facet | Nikhar Kinger, MD Michael J. Hoch, MD Hui-Kuo G. Shu, MD Brent D. Weinberg, MD, PhD |
| author_sort | Nikhar Kinger, MD |
| collection | DOAJ |
| description | In brain tumor patients, worsening of imaging findings in the first 6 months after surgical debulking and chemoradiation can occur in the absence of tumor growth, a phenomenon known as pseudoprogression. Awareness of pseudoprogression is important as it can lead to unnecessary additional changes in patient management. In this case, a patient with bilateral frontal glioblastoma presented with new post-treatment brainstem leptomeningeal enhancement which was distant from the original tumor site, concerning for disease progression. However, the patient was asymptomatic and correlation of leptomeningeal enhancement locations with radiation therapy dose maps revealed high doses at the affected site, supporting a diagnosis of treatment effect which was confirmed by resolution on follow-up imaging after treatment with steroids. Parenchymal pseudoprogression in brain tumor patients is well-documented, but worsening leptomeningeal enhancement following therapy may also represent treatment effects. If spatially remote leptomeningeal enhancement occurs, correlation with radiation dose maps may be useful in suggesting a diagnosis of treatment effect over tumor progression. Keywords: Pseudoprogression, Leptomeningeal enhancement, Glioblastoma, Radiation therapy |
| first_indexed | 2024-12-14T03:35:48Z |
| format | Article |
| id | doaj.art-25e650024aa642d8bfcb72d6be7cae50 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-14T03:35:48Z |
| publishDate | 2019-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-25e650024aa642d8bfcb72d6be7cae502022-12-21T23:18:37ZengElsevierRadiology Case Reports1930-04332019-05-01145613617Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapyNikhar Kinger, MD0Michael J. Hoch, MD1Hui-Kuo G. Shu, MD2Brent D. Weinberg, MD, PhD3Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd NE, BG20, Atlanta, GA 30322 USADepartment of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd NE, BG20, Atlanta, GA 30322 USADepartment of Radiation Oncology, Emory University, Atlanta, GA, USADepartment of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd NE, BG20, Atlanta, GA 30322 USA; Corresponding author.In brain tumor patients, worsening of imaging findings in the first 6 months after surgical debulking and chemoradiation can occur in the absence of tumor growth, a phenomenon known as pseudoprogression. Awareness of pseudoprogression is important as it can lead to unnecessary additional changes in patient management. In this case, a patient with bilateral frontal glioblastoma presented with new post-treatment brainstem leptomeningeal enhancement which was distant from the original tumor site, concerning for disease progression. However, the patient was asymptomatic and correlation of leptomeningeal enhancement locations with radiation therapy dose maps revealed high doses at the affected site, supporting a diagnosis of treatment effect which was confirmed by resolution on follow-up imaging after treatment with steroids. Parenchymal pseudoprogression in brain tumor patients is well-documented, but worsening leptomeningeal enhancement following therapy may also represent treatment effects. If spatially remote leptomeningeal enhancement occurs, correlation with radiation dose maps may be useful in suggesting a diagnosis of treatment effect over tumor progression. Keywords: Pseudoprogression, Leptomeningeal enhancement, Glioblastoma, Radiation therapyhttp://www.sciencedirect.com/science/article/pii/S1930043318305600 |
| spellingShingle | Nikhar Kinger, MD Michael J. Hoch, MD Hui-Kuo G. Shu, MD Brent D. Weinberg, MD, PhD Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy Radiology Case Reports |
| title | Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| title_full | Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| title_fullStr | Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| title_full_unstemmed | Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| title_short | Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| title_sort | glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1930043318305600 |
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