Preoperative chemotherapy for infiltrative low-grade oligoastrocytoma: A useful strategy to maximize surgical resection

Abstract

A 38-year-old woman presented with a large infiltrative left frontal low-grade glioma manifesting as partial seizures of the left arm and lower limb. First line chemotherapy with temozolomide reduced infiltration and volume, allowing subtotal surgical resection. The patient suffered postoperative supplementary motor area syndrome with right hemiparesis and mutism that resolved completely after approximately one month. She was able to return to her full-time job after 4 months. The residual tumor was stable, and the frequency of seizures had lessened dramatically at the last follow-up examination at 18 months. The present case demonstrates that this new therapeutic approach of chemotherapy followed by surgery can offer safer and more radical surgical resection, improving the quality of life of the patient.