Cerebral peduncle tumor ablated by novel 3-mm laser tip

Stereotact Funct Neurosurg. 2015;93(1):38-41. doi: 10.1159/000368907. Epub 2015 Jan 31.

Abstract

Background/objective: Decisions to use open surgery or radiotherapy in pediatric patients with familial neoplastic syndromes must consider not only the symptomatic benefits of treatment, but also future limitations these treatments may impose. Specifically, open surgical resection of noncurable tumors may preclude or encumber future lesion resections, while radiotherapy has detrimental effects on pediatric cognitive development and increases the risk of future malignancy development. We provide the first report of using a novel 3.0-mm diffusing laser tip with laser-induced thermal therapy (LiTT) to treat a pediatric patient with neurofibromatosis type 1 (NF-1).

Methods: A 12-year-old boy with NF-1 presented with a progressively enlarging lesion in the right midbrain. A stereotactic biopsy was performed, followed by LiTT with a novel 3.0-mm laser applicator.

Results: MRI 1 week after LiTT showed stable gross total ablation of the lesion with reduction in fluid-attenuated inversion recovery signal. The patient remained neurologically intact 6 months after his procedure, and follow-up MRI showed no evidence of recurrence.

Conclusion: LiTT is a powerful adjunct to conventional open surgical and radiotherapy modalities in the treatment of patients with familial neoplastic syndromes or incurable lesions. The novel laser applicator tip described expands the treatment scope of this technique.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Astrocytoma / drug therapy
  • Astrocytoma / radiotherapy
  • Bevacizumab / administration & dosage
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Cerebral Peduncle / surgery*
  • Child
  • Combined Modality Therapy
  • Dacarbazine / administration & dosage
  • Dacarbazine / analogs & derivatives
  • Glioma / genetics
  • Glioma / surgery*
  • Humans
  • Infratentorial Neoplasms / genetics
  • Infratentorial Neoplasms / surgery*
  • Irinotecan
  • Laser Therapy / instrumentation*
  • Laser Therapy / methods
  • Male
  • Neoplasms, Multiple Primary / radiotherapy
  • Neoplasms, Multiple Primary / surgery
  • Neurofibromatosis 1 / surgery*
  • Neuroimaging
  • Optic Nerve Glioma / radiotherapy
  • Supratentorial Neoplasms / drug therapy
  • Supratentorial Neoplasms / radiotherapy
  • Temozolomide

Substances

  • Bevacizumab
  • Irinotecan
  • Dacarbazine
  • Camptothecin
  • Temozolomide