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Pineal Region Glioblastoma, a Case Report and Literature Review.

Authors:
Hayley Beacher Stowe C Ryan Miller Jing Wu Dina M Randazzo Andrew Wenhua Ju

Front Oncol 2017 12;7:123. Epub 2017 Jun 12.

Department of Radiation Oncology, Brody School of Medicine, Greenville, NC, United States.

Introduction: Pineal region glioblastoma multiforme (GBM) is a rare disease entity with a generally poor prognosis. We present a case of a patient with an unresectable pineal region GBM treated with chemoradiation with favorable outcome.

Case Background: A 65-year-old patient who was presented with visual symptoms was found to have a pineal region tumor on imaging. A stereotactic biopsy showed a World Health Organization Grade IV GBM, -6-methylguanine-DNA methyltransferase (MGMT) promoter methylated, isocitrate dehydrogenase 1 and 2 wild type. The patient was treated with radiotherapy with concurrent temozolomide, followed by adjuvant temozolomide. Disease progression occurred at 58 weeks post-biopsy, which prompted the initiation of bevacizumab. The patient was alive and functioning well as of his last follow up, 166 weeks from the initial biopsy.

Discussion: On our review of the literature, 24 cases of pineal region GBM have been reported. The median reported survival for these previously reported cases was 6 months (range, 2-24 months). This patient has the longest overall survival reported to date for a patient with this diagnosis. This is the first patient in the literature with pineal region GBM who has been reported to have MGMT promoter methylation.

Concluding Remarks: Although pineal region GBM is a rare disease entity with a generally poor prognosis, long-term survival is achievable for select patients. MGMT promoter methylation may potentially have prognostic value. Favorable control of recurrent disease with the use of bevacizumab is possible.

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http://dx.doi.org/10.3389/fonc.2017.00123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466962PMC
June 2017

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