Seizure freedom from recurrent insular low-grade glioma following laser interstitial thermal therapy

• Published in: Child's nervous system Vol. 36; no. 5; pp. 1055 - 1059
• Main Authors: Easwaran, TP, Lion, A, Vortmeyer, AO, Kingery, K, BC, McDonald, Raskin, JS
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2020
• Subjects: Case Report; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Pediatric; MRGLITT; Low-grade glioma; Seizures
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-019-04493-6

Pediatric low-grade gliomas (LGGs) are found in approximately 1–3% of patients with childhood epilepsy that is often medically refractory. Magnetic resonance guided laser interstitial thermal therapy (MRgLITT) is a minimal access technique FDA-approved since 2007 to ablate soft tissue lesions including brain tumors and seizure foci in children. The authors describe the case of an 11-year-old boy who presented with focal right-sided seizures and was found to have a growing left insular mass determined to be a WHO grade II diffuse astrocytoma. After the initial open resection using frontotemporal craniotomy with transsylvian approach, gross total resection was achieved; however, the tumor recurred, as did the seizures. Six months postoperatively, the patient underwent laser ablation with MRgLITT for the recurrent tumor with complete removal. At both 1- and 6-months post re-operation, he has remained seizure free. MRgLITT management of LGG allows for both successfully reducing tumor burden and the amelioration of secondary seizures.