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Progression of Low-Grade Glioma During Pregnancy With Subsequent Regression Postpartum Without Treatment-A Case Report.

Authors
  • Shah, Amar S1
  • Nicoletti, Lisa K1
  • Kurtovic, Elvisa1
  • Tsien, Christina I2
  • Benzinger, Tammie L S3
  • Chicoine, Michael R1
  • 1 Department of Neurosurgery, Washington University in St. Louis, St. Louis, Missouri.
  • 2 Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri.
  • 3 Department of Radiology, Washington University in St. Louis, St. Louis, Missouri.
Type
Published Article
Journal
Neurosurgery
Publication Date
Jun 01, 2019
Volume
84
Issue
6
Identifiers
DOI: 10.1093/neuros/nyy191
PMID: 29788426
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This report illustrates a case of a low-grade glioma that showed significant disease progression during pregnancy, and then subsequent regression spontaneously in the postpartum period without treatment. This is a rare case of spontaneous glioma regression in the postpartum period, and may suggest underlying mechanisms of hormonal influences upon glioma progression. The patient is a 27-yr-old female who underwent placement of a right-sided ventriculoperitoneal shunt for aqueductal stenosis at 8 wk of age. At the age of 24 yr, she was evaluated for chronic headaches and was found on magnetic resonance imaging (MRI) for the first time to have a small nonenhancing tectal glioma that remained stable on follow-up MRI. At the age of 25 yr, she returned for annual follow-up after giving birth and reported a significant increase in headache frequency and severity during the pregnancy. Repeat imaging now showed a larger, contrast-enhancing lesion. A decision was made to pursue radiosurgery, but during the pretreatment planning phase, the lesion and symptoms regressed spontaneously, and the lesion has remained stable on repeat MRI studies over a 30-mo period since delivery of her child. A young woman with a tectal glioma developed symptomatic disease progression during pregnancy, and subsequently had regression of the lesion and symptoms in the postpartum period without treatment. This case supports watchful waiting in select cases and suggests a potential role of hormones in glioma progression. Copyright © 2018 by the Congress of Neurological Surgeons.

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