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Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy.
J Neurosurg Pediatr. 2011 Nov; 8(5):468-75.JN

Abstract

Supratentorial primitive neuroectodermal tumors (PNETs) are rare tumors that carry a poorer prognosis than those arising from the infratentorial compartment (such as medulloblastoma). The overall prognosis for these patients depends on several factors including the extent of resection, age at diagnosis, CSF dissemination, and site in the supratentorial space. The authors present the first case of a patient with a newly diagnosed supratentorial PNET in which cytoreduction was achieved with MR-guided laser-induced thermal therapy. A 10-year-old girl presented with left-sided facial weakness and a large right thalamic mass extending into the right midbrain. The diagnosis of supratentorial PNET was made after stereotactic biopsy. Therapeutic options for this lesion were limited because of the risks of postoperative neurological deficits with resection. The patient underwent MR-guided laser-induced thermal ablation of her tumor. Under real-time MR thermometry, thermal energy was delivered to the tumor at a core temperature of 90°C for a total of 960 seconds. The patient underwent follow-up MR imaging at regular intervals to evaluate the tumor response to the thermal ablation procedure. Initial postoperative scans showed an increase in the size of the lesion as well as the amount of the associated edema. Both the size of the lesion and the edema stabilized by 1 week and then decreased below preablation levels at the 3-month postsurgical follow-up. There was a slight increase in the size of the lesion and associated edema at the 6-month follow-up scan, presumably due to concomitant radiation she received as part of her postoperative care. The patient tolerated the procedure well and has had resolution of her symptoms since surgery. Further study is needed to assess the role of laser-induced thermal therapy for the treatment of intracranial tumors. As such, it is a promising tool in the neurosurgical armamentarium. Postoperative imaging has shown no evidence of definitive recurrence at the 6-month follow-up period, but longer-term follow-up is required to assess for late recurrence.

Authors+Show Affiliations

Department of Neurosurgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22044371

Citation

Jethwa, Pinakin R., et al. "Treatment of a Supratentorial Primitive Neuroectodermal Tumor Using Magnetic Resonance-guided Laser-induced Thermal Therapy." Journal of Neurosurgery. Pediatrics, vol. 8, no. 5, 2011, pp. 468-75.
Jethwa PR, Lee JH, Assina R, et al. Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy. J Neurosurg Pediatr. 2011;8(5):468-75.
Jethwa, P. R., Lee, J. H., Assina, R., Keller, I. A., & Danish, S. F. (2011). Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy. Journal of Neurosurgery. Pediatrics, 8(5), 468-75. https://doi.org/10.3171/2011.8.PEDS11148
Jethwa PR, et al. Treatment of a Supratentorial Primitive Neuroectodermal Tumor Using Magnetic Resonance-guided Laser-induced Thermal Therapy. J Neurosurg Pediatr. 2011;8(5):468-75. PubMed PMID: 22044371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy. AU - Jethwa,Pinakin R, AU - Lee,Jason H, AU - Assina,Rachid, AU - Keller,Irwin A, AU - Danish,Shabbar F, PY - 2011/11/3/entrez PY - 2011/11/3/pubmed PY - 2011/12/23/medline SP - 468 EP - 75 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 8 IS - 5 N2 - Supratentorial primitive neuroectodermal tumors (PNETs) are rare tumors that carry a poorer prognosis than those arising from the infratentorial compartment (such as medulloblastoma). The overall prognosis for these patients depends on several factors including the extent of resection, age at diagnosis, CSF dissemination, and site in the supratentorial space. The authors present the first case of a patient with a newly diagnosed supratentorial PNET in which cytoreduction was achieved with MR-guided laser-induced thermal therapy. A 10-year-old girl presented with left-sided facial weakness and a large right thalamic mass extending into the right midbrain. The diagnosis of supratentorial PNET was made after stereotactic biopsy. Therapeutic options for this lesion were limited because of the risks of postoperative neurological deficits with resection. The patient underwent MR-guided laser-induced thermal ablation of her tumor. Under real-time MR thermometry, thermal energy was delivered to the tumor at a core temperature of 90°C for a total of 960 seconds. The patient underwent follow-up MR imaging at regular intervals to evaluate the tumor response to the thermal ablation procedure. Initial postoperative scans showed an increase in the size of the lesion as well as the amount of the associated edema. Both the size of the lesion and the edema stabilized by 1 week and then decreased below preablation levels at the 3-month postsurgical follow-up. There was a slight increase in the size of the lesion and associated edema at the 6-month follow-up scan, presumably due to concomitant radiation she received as part of her postoperative care. The patient tolerated the procedure well and has had resolution of her symptoms since surgery. Further study is needed to assess the role of laser-induced thermal therapy for the treatment of intracranial tumors. As such, it is a promising tool in the neurosurgical armamentarium. Postoperative imaging has shown no evidence of definitive recurrence at the 6-month follow-up period, but longer-term follow-up is required to assess for late recurrence. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/22044371/Treatment_of_a_supratentorial_primitive_neuroectodermal_tumor_using_magnetic_resonance_guided_laser_induced_thermal_therapy_ L2 - https://thejns.org/doi/10.3171/2011.8.PEDS11148 DB - PRIME DP - Unbound Medicine ER -