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

Candice Meyzer 1 Frédéric Dhermain 2, 3 Denis Ducreux 3 Jean-Louis Habrand 2, 4 Pascale Varlet 5 Christian Sainte-Rose 6 Christelle Dufour 1 Jacques Grill 1, *
* Auteur correspondant
1 Département de Pédiatrie
2 Département de radiothérapie [Gustave Roussy]
3 Stéroides et système nerveux : physiopathologie moléculaire et clinique
4 Centre de Protonthérapie
5 Service de neuropathologie
6 Service de neurochirurgie pédiatrique [CHU Necker]
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.
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Radiation Oncology, BioMed Central, 2010, 5 (1), pp.9. 〈10.1186/1748-717X-5-9〉
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Candice Meyzer, Frédéric Dhermain, Denis Ducreux, Jean-Louis Habrand, Pascale Varlet, et al.. 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. Radiation Oncology, BioMed Central, 2010, 5 (1), pp.9. 〈10.1186/1748-717X-5-9〉. 〈inserm-00668468〉

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