LMI-02AGGRESSIVE GLIOBLASTOMA MULTIFORME AFTER RADIATION THERAPY : A CASE REPORT

Abstract

Second neoplasm is a know complication in patients who receive radiation therapy. We here describe a 9y3m old boy who was diagnosed with Lymphoma/lymphoblastic Leukemia at the age of 3y2m. He was treated with GCBTLNHI-96 protocol for high risk, with good response, and finished therapy in July 2010. Three months post therapy he developed local relapse with CNS involvement and was treated with the same protocol but without response after 5months of therapy. At this point he received bonemarrowtransplantwithMelphalan and TBI conditioning. Three years later started complaining ofheadache and vomiting followed by seizures.MRI showed intra-axialmass and was diagnosed with Glioblastoma multiforme after first resection. At 1 month of radiation therapy he developed signs of increased ICP and underwent subtotal resection. Spine MRI showed neuraxial lesions in intradural topography(T1-T2; T3-T4; T5-T6), so he received Temodal + Radiotherapy scheme (2340Gy + Boost relapsed region 5940Gy + 4500Gy spinemetastasis). He was stable for six months and then developed headache and paresthesia of upper limb andMRI showed worsening of the tumor with edema and bleeding. Soathirdcraniotomywasperformedandreportedtoachieve95%resection.One month afternewdiagnosis, he startedwithheadache, loss of strength in limbs, seizures so a fourth resection of the lesion (approximately 95%) was achieved. Received two cycles of Irinotecan + Avastin with unfavorable evolution; staying under palliative care, evolving to death after new tumoral progression.