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Case Presentation: Pediatric Low-Grade Glioma
Patient Case
A 7-year-old, previously healthy female presented with a 2 month history of headaches, vomiting, and generalized fatigue. Brain MRI demonstrated a posterior fossa mass with resultant obstructive hydrocephalus and spine MRI was negative for other sites of disease. She underwent partial resection of the mass and ventriculoperitoneal shunt placement. The pathology was consistent with a pilocytic astrocytoma and molecular analysis revealed a KIAA1549-BRAF fusion. She underwent front-line chemotherapy with carboplatin and vincristine for 18 months. During and after treatment the size of her tumor remained the same.
She remained clinically well while off therapy, undergoing surveillance brain MRIs at 3 month intervals. When she was approximately 2 years off therapy a routine brain MRI demonstrated disease progression and she began to experience new gait instability. Due to the imaging evidence of progression disease in the setting of new neurologic symptoms she initiated therapy.
