Regression of recurrent glioblastoma infiltrating the brainstem after convection-enhanced delivery of nimustine hydrochloride

J Neurosurg Pediatr. 2011 May;7(5):522-6. doi: 10.3171/2011.2.PEDS10407.

Abstract

This 13-year-old boy with a history of cranial irradiation for the CNS recurrence of acute lymphocytic leukemia developed a glioblastoma in the right cerebellum. Resection and chemo- and radiotherapy induced remission of the disease. However, recurrence was noted in the brainstem region 8 months later. Because no effective treatment was available for this recurrent lesion, the authors decided to use convection-enhanced delivery (CED) to infuse nimustine hydrochloride. On stereotactic insertion of the infusion cannula into the brainstem lesion, CED of nimustine hydrochloride was performed with real-time MR imaging to monitor the co-infused chelated gadolinium. The patient's preinfusion symptom of diplopia disappeared after treatment. Follow-up MR imaging revealed the response of the tumor. The authors report on a case of recurrent glioblastoma infiltrating the brainstem that regressed after CED of nimustine hydrochloride.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Brain Stem Neoplasms / drug therapy*
  • Brain Stem Neoplasms / pathology
  • Brain Stem Neoplasms / surgery
  • Cerebellar Neoplasms / drug therapy*
  • Cerebellar Neoplasms / pathology
  • Cerebellar Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Convection*
  • Cranial Irradiation
  • Drug Delivery Systems / instrumentation*
  • Follow-Up Studies
  • Glioblastoma / drug therapy*
  • Glioblastoma / pathology
  • Glioblastoma / surgery
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasms, Radiation-Induced / drug therapy
  • Neoplasms, Radiation-Induced / pathology
  • Neoplasms, Radiation-Induced / surgery
  • Neoplasms, Second Primary / drug therapy
  • Neoplasms, Second Primary / pathology
  • Neoplasms, Second Primary / surgery
  • Nimustine / administration & dosage*
  • Nimustine / adverse effects
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / radiotherapy
  • Stereotaxic Techniques

Substances

  • Antineoplastic Agents
  • Nimustine