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

• Main Authors: Sainte-Rose Christian, Varlet Pascale, Habrand Jean-Louis, Ducreux Denis, Dhermain Frédéric, Meyzer Candice, Dufour Christelle, Grill Jacques
• Format: Article
• Language: English
• Published: BMC 2010-02-01
• Series: Radiation Oncology
• Online Access: http://www.ro-journal.com/content/5/1/9

<p>Abstract</p> <p>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.</p>