Case 3 History

Presented by:  Dr Chris Ekong, Neurosurgeon, Regina

Consultants:

Dr. Moe Salim. Regina

Dr. Mike Schwartz, Toronto

Dr. May Tsao, Toronto

Dr. James Perry, Toronto

Dr Arie Perry, St Louis

Dr Q. Li, Regina

Age: 36

Sex: Female

History: Sudden right arm focal seizures March '99. Examination - normal

Pre-op CT

CT head March 1999 showing deep left pariental mass with calcification and oedema.

Clinical Diagnosis:  Oligodendroglioma

Treatment:

  • Stereotaxic Biopsy

  • Oligodendroglioma confirmed.

  • Treated with Radiation.  5,4000 cGy July 1999.

Histology Slides

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Oligodendroglioma

Post-op CT

CT of the head with contrast, October 1999 showing almost no tumor.

Progress:

  • June 2000 another seizure.

  • Examination - normal.

Follow-Up CT

CT of the head with contrast, June 2000 showing recurrent  tumor.

Treatment:

  • Radiosurgery considered but rejected

  • 1p and 19q chromosome deletion confirmed.  

  • Chemotherapy with PCV started Sept 2000

  • Excellent reduction in tumor size. 

 

MRI Jan 2002

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recurrent enhancing mass Jan 2002

 

Treatment:

 

MRI May 2002

 

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May 2002 showing shrinkage of tumors.

CT Feb 2003

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CT of brain Feb 2003 showing recurrence

MRI Jan 2003

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MRI Jan 2003 showing recurrent tumor
 
Treatment:
 
Now what?
 
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