Laser Interstitial Thermal Therapy in a Large Thalamic Glioma with Long-Term Remission: A Case Report

• Published in: Oncology research and treatment Vol. 47; no. 1-2; p. 42
• Main Authors: Hoyningen, Alexander, Koster, Kira-Lee, Neidert, Marian C, Bozinov, Oliver, Lauber, Arno, Kim, Olaf Chan-Hi, Hundsberger, Thomas, Krüger, Marie T
• Format: Journal Article
• Language: English
• Published: Switzerland 01.02.2024
• Subjects: Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; Brain Neoplasms - therapy; Female; Glioblastoma; Glioma - diagnostic imaging; Glioma - therapy; Humans; Laser Therapy - methods; Lasers; Magnetic Resonance Imaging; Middle Aged; Remission; Thalamic glioma; Trajectory; Immediate adjuvant chemotherapy and radiation; Laser interstitial thermal therapy
• ISSN: 2296-5262
• DOI: 10.1159/000535991

Thalamic gliomas pose a particular therapeutic challenge as complete resection is rarely achieved due to the deep and eloquent location. Laser interstitial thermal therapy (LITT) may provide a valuable management option for deep-seated gliomas that are not accessible with open surgery. A 57-year-old woman presented with a rapidly progressive large thalamic glioblastoma. Opting for full ablation, we selected a challenging trajectory to maximize the possibility of full ablation. At 2.4 cm in diameter, the tumour was larger than recommended for LITT; nevertheless, three laser ablations along a single trajectory resulted in macroscopic ablation without complications. Adjuvant radio-chemotherapy was started soon after surgery without radiological recurrence 1.5 years after the initial surgery. This case demonstrates the potential when thalamic tumours are managed with timely LITT treatment and meticulous trajectory planning. Moreover, it highlights the need for close interdisciplinary management with neurosurgeons, neuropathologists, neuroradiologists, and neurooncologists.