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Severe Radiation Necrosis Successfully Treated With Bevacizumab in an Infant with Low‐Grade Glioma and Tumor‐Associated Intractable Trigeminal Neuralgia
Author(s) -
Pillay Smiley Natasha,
Alden Tord,
Hartsell William,
Fangusaro Jason
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26055
Subject(s) - medicine , bevacizumab , trigeminal neuralgia , dexamethasone , necrosis , hydrocephalus , glioma , surgery , radiology , pathology , chemotherapy , cancer research
We present a unique case of radiation necrosis in a child with brain stem low‐grade glioma (LGG) presenting with trigeminal neuralgia. Despite extensive therapies, severe pain persisted. She received proton beam radiation with significant improvement. However, she developed radiation necrosis and hydrocephalus. Despite surgical correction of hydrocephalus, the patient remained critically ill. She was treated with dexamethasone and bevacizumab with rapid clinical improvement. Subsequent MRIs revealed almost complete resolution of the necrosis. This case illustrates the successful treatment of trigeminal neuralgia with radiation and a rare case of radiation necrosis in an LGG successfully treated with bevacizumab and dexamethasone.