Very late complications of oncotherapy in glioblastoma patients: A case series
Background. Stroke-like syndrome is defined as a rare, delayed complication of brain oncotherapy. Cases with more favorable brain cancer diagnoses and longer life expectancy have been previously reported, but here we present, for the first time, three long-term survivors of glioblastoma with stroke-...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Palacký University Olomouc, Faculty of Medicine and Dentistry
2022-05-01
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| Series: | Biomedical Papers |
| Subjects: | |
| Online Access: | https://biomed.papers.upol.cz/artkey/bio-202202-0017_very-late-complications-of-oncotherapy-in-glioblastoma-patients-a-case-series.php |
| _version_ | 1818208918894018560 |
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| author | Ondrej Kalita Lumir Hrabalek Matej Halaj Pavel Hok David Franc Yvona Klementova Martin Dolezel Eva Cechakova Zuzana Sporikova Jiri Drabek Marian Hajduch Lucie Tuckova |
| author_facet | Ondrej Kalita Lumir Hrabalek Matej Halaj Pavel Hok David Franc Yvona Klementova Martin Dolezel Eva Cechakova Zuzana Sporikova Jiri Drabek Marian Hajduch Lucie Tuckova |
| author_sort | Ondrej Kalita |
| collection | DOAJ |
| description | Background. Stroke-like syndrome is defined as a rare, delayed complication of brain oncotherapy. Cases with more favorable brain cancer diagnoses and longer life expectancy have been previously reported, but here we present, for the first time, three long-term survivors of glioblastoma with stroke-like syndromes. Methods and Results. Three young or middle-aged patients underwent tumor resection and chemoradiotherapy. They received regular clinical and imaging follow-up with stable neurological status and no signs of tumor recurrence. They exhibited varied signs and symptoms (motor and sensory deficits, aphasia, memory and cognitive disorders, seizures, and headache) accompanied by imaging abnormalities. Stroke-like syndromes developed within 2-5 days and resolved in 2-6 weeks. Diffusion-weighted MRI and T2 brain perfusion abnormalities were demonstrated in all patients. In addition, there was focal T1 MRI contrast enhancement due to blood-brain barrier disruption. In addition to tumor recurrence, classic stroke, encephalitis, metabolic and mitochondrial disorders, and post-seizure swelling should be excluded. The imaging indicated intensive MRI scanning and symptomatic medication (steroids supplemented by antiepileptics, vasoactive agents, etc.) for judicious management. With respect to the course, an invasive procedure was still considered an option. Conclusion. All stroke-like syndromes are diagnoses of exclusion. To avoid misinterpretation of imaging findings as glioblastoma recurrence and avert recall oncotherapy or redundant interventions, better understanding of delayed complications of brain tumor therapy is crucial. |
| first_indexed | 2024-12-12T04:52:27Z |
| format | Article |
| id | doaj.art-d7a52352eed149bba87e1600fc803e11 |
| institution | Directory Open Access Journal |
| issn | 1213-8118 1804-7521 |
| language | English |
| last_indexed | 2024-12-12T04:52:27Z |
| publishDate | 2022-05-01 |
| publisher | Palacký University Olomouc, Faculty of Medicine and Dentistry |
| record_format | Article |
| series | Biomedical Papers |
| spelling | doaj.art-d7a52352eed149bba87e1600fc803e112022-12-22T00:37:26ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212022-05-01166223624110.5507/bp.2021.012bio-202202-0017Very late complications of oncotherapy in glioblastoma patients: A case seriesOndrej Kalita0Lumir Hrabalek1Matej Halaj2Pavel Hok3David Franc4Yvona Klementova5Martin Dolezel6Eva Cechakova7Zuzana Sporikova8Jiri Drabek9Marian Hajduch10Lucie Tuckova11Department of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Neurology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Neurology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Oncology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Radiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicLaboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicLaboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicLaboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Pathology and Laboratory of Molecular Pathology, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicBackground. Stroke-like syndrome is defined as a rare, delayed complication of brain oncotherapy. Cases with more favorable brain cancer diagnoses and longer life expectancy have been previously reported, but here we present, for the first time, three long-term survivors of glioblastoma with stroke-like syndromes. Methods and Results. Three young or middle-aged patients underwent tumor resection and chemoradiotherapy. They received regular clinical and imaging follow-up with stable neurological status and no signs of tumor recurrence. They exhibited varied signs and symptoms (motor and sensory deficits, aphasia, memory and cognitive disorders, seizures, and headache) accompanied by imaging abnormalities. Stroke-like syndromes developed within 2-5 days and resolved in 2-6 weeks. Diffusion-weighted MRI and T2 brain perfusion abnormalities were demonstrated in all patients. In addition, there was focal T1 MRI contrast enhancement due to blood-brain barrier disruption. In addition to tumor recurrence, classic stroke, encephalitis, metabolic and mitochondrial disorders, and post-seizure swelling should be excluded. The imaging indicated intensive MRI scanning and symptomatic medication (steroids supplemented by antiepileptics, vasoactive agents, etc.) for judicious management. With respect to the course, an invasive procedure was still considered an option. Conclusion. All stroke-like syndromes are diagnoses of exclusion. To avoid misinterpretation of imaging findings as glioblastoma recurrence and avert recall oncotherapy or redundant interventions, better understanding of delayed complications of brain tumor therapy is crucial.https://biomed.papers.upol.cz/artkey/bio-202202-0017_very-late-complications-of-oncotherapy-in-glioblastoma-patients-a-case-series.phpstroke-like syndromeglioblastomaoncotherapycorticosteroid |
| spellingShingle | Ondrej Kalita Lumir Hrabalek Matej Halaj Pavel Hok David Franc Yvona Klementova Martin Dolezel Eva Cechakova Zuzana Sporikova Jiri Drabek Marian Hajduch Lucie Tuckova Very late complications of oncotherapy in glioblastoma patients: A case series Biomedical Papers stroke-like syndrome glioblastoma oncotherapy corticosteroid |
| title | Very late complications of oncotherapy in glioblastoma patients: A case series |
| title_full | Very late complications of oncotherapy in glioblastoma patients: A case series |
| title_fullStr | Very late complications of oncotherapy in glioblastoma patients: A case series |
| title_full_unstemmed | Very late complications of oncotherapy in glioblastoma patients: A case series |
| title_short | Very late complications of oncotherapy in glioblastoma patients: A case series |
| title_sort | very late complications of oncotherapy in glioblastoma patients a case series |
| topic | stroke-like syndrome glioblastoma oncotherapy corticosteroid |
| url | https://biomed.papers.upol.cz/artkey/bio-202202-0017_very-late-complications-of-oncotherapy-in-glioblastoma-patients-a-case-series.php |
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