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Seizure freedom from recurrent insular low-grade glioma following laser interstitial thermal therapy

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Abstract

Pediatric low-grade gliomas (LGGs) are found in approximately 1–3% of patients with childhood epilepsy that is often medically refractory. Magnetic resonance guided laser interstitial thermal therapy (MRgLITT) is a minimal access technique FDA-approved since 2007 to ablate soft tissue lesions including brain tumors and seizure foci in children. The authors describe the case of an 11-year-old boy who presented with focal right-sided seizures and was found to have a growing left insular mass determined to be a WHO grade II diffuse astrocytoma. After the initial open resection using frontotemporal craniotomy with transsylvian approach, gross total resection was achieved; however, the tumor recurred, as did the seizures. Six months postoperatively, the patient underwent laser ablation with MRgLITT for the recurrent tumor with complete removal. At both 1- and 6-months post re-operation, he has remained seizure free. MRgLITT management of LGG allows for both successfully reducing tumor burden and the amelioration of secondary seizures.

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References

  1. Ashraf O, Patel NV, Hanft S, Danish SF (2018) Laser-induced thermal therapy in neuro-oncology: a review. World Neurosurg 112:166–177

    Article  Google Scholar 

  2. Barnett GH, Voigt JD, Alhuwalia MS (2016) A systematic review and meta-analysis of studies examining the use of brain laser interstitial thermal therapy versus craniotomy for the treatment of high-grade tumors in or near areas of eloquence: an examination of the extent of resection and major complication rates associated with each type of surgery. Stereotact Funct Neurosurg 94(3):164–173

    Article  Google Scholar 

  3. Curry DJ, Gowda A, McNichols R, Wilfong AA (2012) MR-guided stereotactic laser ablation of epileptogenic foci in children. Epilepsy Behav 24(4):408–414

    Article  Google Scholar 

  4. Englot DJ, Berger MS, Barbaro NM, Chang EF (2011) Predictors of seizure freedom after resection of supratentorial low-grade gliomas. A review. J Neurosurg 115(2):240–244

    Article  Google Scholar 

  5. Fayed I, Sacino MF, Gaillard WD, Keating RF, Oluigbo CO (2018) MR-guided laser interstitial thermal therapy for medically refractory lesional epilepsy in pediatric patients: experience and outcomes. Pediatr Neurosurg 53(5):322–329

    Article  Google Scholar 

  6. Kerkhof M, Vecht CJ (2013) Seizure characteristics and prognostic factors of gliomas. Epilepsia 54(Suppl 9):12–17

    Article  Google Scholar 

  7. Medvid R, Ruiz A, Komotar RJ, Jagid JR, Ivan ME, Quencer RM, Desai MB (2015) Current applications of MRI-guided laser interstitial thermal therapy in the treatment of brain neoplasms and epilepsy: a radiologic and neurosurgical overview. AJNR Am J Neuroradiol 36(11):1998–2006

    Article  CAS  Google Scholar 

  8. Perry MS, Donahue DJ, Malik SI, Keator CG, Hernandez A, Reddy RK, Perkins FF, Lee MR, Clarke DF (2017) Magnetic resonance imaging-guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatr 20(6):575–582

    Article  Google Scholar 

  9. Rahmathulla G, Recinos PF, Kamian K, Mohammadi AM, Ahluwalia MS, Barnett GH (2014) MRI-guided laser interstitial thermal therapy in neuro-oncology: a review of its current clinical applications. Oncology 87(2):67–82

    Article  Google Scholar 

  10. Sanai N, Polley MY, Berger MS (2010) Insular glioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg 112(1):1–9

    Article  Google Scholar 

  11. Sievert AJ, Fisher MJ (2009) Pediatric low-grade gliomas. J Child Neurol 24(11):1397–1408

    Article  Google Scholar 

  12. Tovar-Spinoza Z, Choi H (2016) Magnetic resonance-guided laser interstitial thermal therapy: report of a series of pediatric brain tumors. J Neurosurg Pediatr 17(6):723–733

    Article  Google Scholar 

  13. Ullrich NJ (2009) Neurologic sequelae of brain tumors in children. J Child Neurol 24(11):1446–1454

    Article  Google Scholar 

  14. Wells EM, Gaillard WD, Packer RJ (2012) Pediatric brain tumors and epilepsy. Semin Pediatr Neurol 19(1):3–8

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Section of Pediatric Neurosurgery, Riley Hospital for Children, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    TP Easwaran & JS Raskin

  2. Section of Pediatric Hematology/Oncology, Riley Hospital for Children, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    A Lion

  3. Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA

    AO Vortmeyer

  4. Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA

    K Kingery

  5. Departments of Radiology and Imaging Sciences, Neurology, and Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

    McDonald BC

Authors
  1. TP Easwaran
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  2. A Lion
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  3. AO Vortmeyer
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  4. K Kingery
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  5. McDonald BC
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  6. JS Raskin
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Correspondence to JS Raskin.

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Easwaran, T., Lion, A., Vortmeyer, A. et al. Seizure freedom from recurrent insular low-grade glioma following laser interstitial thermal therapy. Childs Nerv Syst 36, 1055–1059 (2020). https://doi.org/10.1007/s00381-019-04493-6

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  • DOI: https://doi.org/10.1007/s00381-019-04493-6

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