Temozolomide-induced partial response in a patient with primary diffuse leptomeningeal gliomatosis

Franceschi, Enrico; Cavallo, Giovanna; Scopece, L.; Esposti, R. Degli; Paioli, G.; Paioli, Anna; Palmerini, Emanuela; Foschini, Maria Pia; Marliani, Anna Federica; Crinò, Lucio

doi:10.1007/s11060-004-5672-5

Cited by 32 publications

(21 citation statements)

References 10 publications

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“…Leptomeningeal dissemination of LGA is so rare that no treatment protocol for the situation is currently under evaluation. The ideal treatment is still under discussion 12,13 , but it has been suggested that chemotherapy instead of radiotherapy should be initially used 8 .…”

Section: Fig 8 Mri Sagittal Contrast-enhanced T1-weighted Image Of mentioning

confidence: 99%

Unusual dissemination patterns of low-grade astrocytomas in childhood

Rondinelli

Osório

Cohen

et al. 2008

Arq. Neuro-Psiquiatr.

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-Context: Low-grade astrocytomas are intracerebral lesions of relatively high frequency in the under-18 pediatric population. They often present indolent behaviour, and complete surgical resection is the choice treatment. In cases where the surgery is not possible, chemotherapy and radiotherapy may be used. Medical reports do not recommend examination of the spinal cord at diagnosis or during treatment, since the risk of dissemination of the lesion to the spine is minimal according to medical experience. We describe here four cases of children with low-grade astrocytoma with aggressive dissemination to the neuroaxis.KEY WORDS: astrocytomas, pilocytic astrocytoma, brainstem tumor, brain neoplasms, children. padrões incomuns de disseminação dos astrocitomas de baixo grau na infânciaResumo -Contexto: Gliomas de baixo grau de malignidade são lesões intracerebrais relativamente freqüentes na população pediátrica menor de 18 anos de idade. Eles freqüentemente são indolentes em seu comportamento e a ressecção cirúrgica completa é o tratmento de eleição. Nos casos em que a cirurgia não é possível, a quimioterapia e a radioterapia podem ser utilizadas. Relatos da literatura não recomendam a avaliação radiológica da coluna espinhal ao diagnóstico ou durante o tratamento, desde que o risco de disseminação destas lesões para a coluna é considerado mínimo. Descrevemos aqui quatro casos de crianças com gliomas de baixo grau de malignidade com disseminação agressiva para o neuroeixo. PALAVRAS-CHAVE: astrocitomas, astrocitoma pilocítico, tumor de tronco cerebral, tumor cerebral, criança.

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Section: Fig 8 Mri Sagittal Contrast-enhanced T1-weighted Image Of mentioning

confidence: 99%

Unusual dissemination patterns of low-grade astrocytomas in childhood

Rondinelli

Osório

Cohen

et al. 2008

Arq. Neuro-Psiquiatr.

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“…Given that the recent multicenter phase 3 trial demonstrated a significant survival benefit from combining temozolomide and radiotherapy in the treatment of newly diagnosed glioblastoma [37], we opted for systemic treatment with temozolomide combined with radiotherapy in all of our patients. A recent report on a single case of PDLG has also suggested that temozolomide may be beneficial [26]. Survival time from onset of symptoms (74 weeks) was nearly twice as long as is typically seen in PDLG (41 weeks).…”

Section: Discussionmentioning

confidence: 93%

“…The development and use of MRI has increased this figure to 91% [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. Additionally, MRI of the spine has revealed abnormalities in 100% of the reported cases studied in this fashion [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. Clearly, the number of reported cases of PDLG has increased parallel to the development and use of MRI as a clinical adjuvant.…”

Section: Discussionmentioning

confidence: 99%

“…Almost universally, the diagnosis of PDLG is made only by meningeal biopsy or autopsy [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. Only a single case in the literature documents a definitive diagnosis of glioma from CSF cytologic studies [23].…”

Section: Discussionmentioning

confidence: 99%

“…Less than one sixth of all reported cases even demonstrate cellular atypia [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. The CSF leukocyte count is abnormal but only slightly elevated (mean: 25 cells/mm 3 ) given the severity of disease in these patients [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. In contrast, the opening pressure is typically markedly elevated (mean: 448 mm H 2 O) and the protein concentration is often extremely high (mean: 873 mg/dl) [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27].…”

Section: Discussionmentioning

confidence: 99%

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Primary Diffuse Leptomeningeal Gliomatosis

et al. 2009

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Background: Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare presentation of a primary central nervous system glial tumor. Methods: Four case reports of PDLG in young males aged 14–24 years are presented. These reports are discussed in the context of the existing literature. Results: The clinical presentation of 4 new cases of PDLG resembled chronic meningitis with and without polyradiculopathy. Spinal fluid studies are typically nondiagnostic, but characteristically show elevated opening pressure, an elevated protein level, and a relative paucity of cellular reaction. An accurate antemortem diagnosis required contrast-enhanced imaging and meningeal biopsy in all 4 of our cases. Treatment strategies including craniospinal radiation and chemotherapeutic approaches, alone or in combination, have not been proven to alter the course of the disease. Initial responses to temozolomide and radiation treatments in all 4 of our cases were promising, resulting in temporary stabilization of the disease and prolonging life expectancy over what was previously reported in the literature. Conclusion: Total neuroaxis contrast-enhanced MRI scanning is required for directing biopsy confirmation and detecting the extent of the disease. More effective therapeutic strategies are needed, but the combination of temozolomide and radiation therapy may slow disease progression.

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A case of primary diffuse leptomeningeal gliomatosis

Yamasaki

Yokogami

Ohta³

et al. 2014

Brain Tumor Pathol

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Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare and fatal disease characterized by diffuse infiltration of the leptomeninges by neoplastic glial cells without evidence of tumor in the brain parenchyma or spinal cord. We report a 60-year-old man with PDLG. He suffered transient right hemiparesis and generalized seizures. MRI showed diffuse leptomeningeal thickening and enhancement throughout the brain and spinal cord without any intraaxial involvement. Biopsy resulted in a diagnosis of glioblastoma with methylated MGMT promoter and wild-type IDH1. He underwent craniospinal radiotherapy and temozolomide treatment but despite concomitant adjuvant therapy he died 8 months after initial presentation.

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Temozolomide-induced partial response in a patient with primary diffuse leptomeningeal gliomatosis

Cited by 32 publications

References 10 publications

Unusual dissemination patterns of low-grade astrocytomas in childhood

Unusual dissemination patterns of low-grade astrocytomas in childhood

Primary Diffuse Leptomeningeal Gliomatosis

A case of primary diffuse leptomeningeal gliomatosis

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