RT Journal Article
SR Electronic
A1 Kalita, Ondrej
A1 Hrabalek, Lumir
A1 Halaj, Matej
A1 Hok, Pavel
A1 Franc, David
A1 Klementova, Yvona
A1 Dolezel, Martin
A1 Cechakova, Eva
A1 Sporikova, Zuzana
A1 Drabek, Jiri
A1 Hajduch, Marian
A1 Tuckova, Lucie
T1 Very late complications of oncotherapy in glioblastoma patients: A case series
JF Biomedical papers
YR 2022
VO 166
IS 2
SP 236
OP 241
DO 10.5507/bp.2021.012
UL https://biomed.papers.upol.cz/artkey/bio-202202-0017.php
AB Background. Stroke-like syndrome is defined as a rare, delayed complication of brain oncotherapy. Cases with more favorable brain cancer diagnoses and longer life expectancy have been previously reported, but here we present, for the first time, three long-term survivors of glioblastoma with stroke-like syndromes. Methods and Results. Three young or middle-aged patients underwent tumor resection and chemoradiotherapy. They received regular clinical and imaging follow-up with stable neurological status and no signs of tumor recurrence. They exhibited varied signs and symptoms (motor and sensory deficits, aphasia, memory and cognitive disorders, seizures, and headache) accompanied by imaging abnormalities. Stroke-like syndromes developed within 2-5 days and resolved in 2-6 weeks. Diffusion-weighted MRI and T2 brain perfusion abnormalities were demonstrated in all patients. In addition, there was focal T1 MRI contrast enhancement due to blood-brain barrier disruption. In addition to tumor recurrence, classic stroke, encephalitis, metabolic and mitochondrial disorders, and post-seizure swelling should be excluded. The imaging indicated intensive MRI scanning and symptomatic medication (steroids supplemented by antiepileptics, vasoactive agents, etc.) for judicious management. With respect to the course, an invasive procedure was still considered an option. Conclusion. All stroke-like syndromes are diagnoses of exclusion. To avoid misinterpretation of imaging findings as glioblastoma recurrence and avert recall oncotherapy or redundant interventions, better understanding of delayed complications of brain tumor therapy is crucial.