Case ReportRegression of Recurrent High-Grade Glioma with Temozolomide, Dexamethasone, and Levetiracetam: Case Report and Review of the Literature
Introduction
Recurrent glioma of the brain is an incurable disease. Treatment options for recurrent glioma include chemotherapy, radiotherapy, surgery, and palliation. Temozolomide appears to be effective in patients with recurrent high-grade gliomas.1 In vitro and retrospective studies have shown dexamethasone and levetiracetam to inhibit tumor proliferation directly and to increase sensitivity to chemotherapy.2
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Case Description
A 35-year-old woman presented with headache, vomiting, executive memory loss, and decreased sleep. Computed tomography of the brain showed an ill-defined heterogeneous mass 5 × 5 cm involving both frontal lobes and genu of corpus callosum. Multiple discrete, small calcifications were seen in the lesion. Significant perilesional edema was seen in bilateral frontal white matter (Figure 1). Magnetic resonance imaging (MRI) of the brain showed a bifrontal diffuse hyperintense lesion with a
Discussion and Review of Literature
High-grade glioma is an aggressive form of brain cancer. Treatment usually entails biopsy or resection if safe, followed by radiotherapy. Despite aggressive treatment, high-grade malignant gliomas (anaplastic astrocytoma and glioblastoma multiforme) have a poor prognosis.3 Most malignant gliomas (at least 70%) recur after initial treatment.1 Responses in recurrent disease are not enduring, and quality of life because of tumor growth is poor. Tumors with oligodendroglial components have improved
Conclusions
This is a report of a middle-aged woman with corpus callosal anaplastic glioma who had recurrence after surgery and chemoradiotherapy. She experienced near total remission after the recurrence with temozolomide, levetiracetam, and dexamethasone. A few similar cases of regression of high-grade glioma with these drugs have been reported in the literature. Similar reports give more hope in the treatment of recurrent high-grade glioma.
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2022, Cellular SignallingCitation Excerpt :Glucocorticoids (GCs) are currently used in the management of cerebral edema [20,21]. Although it is widely accepted that GCs suppress inflammation and alleviate vasogenic oedema by restoring blood brain barrier integrity [22–24], the effects of GCs on glioma development remain unknown. Dexamethasone (Dex), as a potent anti-inflammatory factor, is frequently used in the treatment of rheumatoid arthritis [25,26].
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.