5^th International Conference on Neuro-Oncology and Brain Tumor August 14-15, 2019 Tokyo, Japan

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Young-Cho Koh is a Neurosurgeon at Konkuk University Hospital, South Korea.

 

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From 2009 to 2017, 215 patients with brain metastases were treated by Stereotactic Radiosurgery (SRS), among which 58 patients underwent surgery. Sixteen of them underwent surgery after SRS due to neurological deterioration, of which pathologies were classified as three groups. Group-1 was radiation necrosis (n=5), group-2 was mixed type with radiation necrosis and tumor remnant (n=2) and group-3 was tumor dominant type (n=9). We compared the surgical outcomes in respect of steroid and/or Mannitol dosage, Karnofsky performance scale and pathological subgroups. The median overall survival was 11 months (range, 2-40 months). Six, 12 and 24 months survival rates were 64.3, 42.9 and 28.6 months, respectively. Improvement of KPS was achieved in 50% of cases after surgery. The overall survival of the group-1 (26.6 months) was significantly longer than the other groups (11.5 months). Additionally the patients were able to be weaned from medications after surgery in 12 cases and dosage reduction in six cases. The time interval within three months between the SRS and surgery seemed to be related with better local control. We suggest in patients with brain metastases who had undergone SRS and radiologic and symptomatic progression, palliative resection to relieve neurologic and radiologic deterioration.

 

 

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Kiran Grant graduated with honors from the BHSc program in Health Sciences from University of Calgary, Alberta. Kiran is currently enrolled in the Medicine Faculty of University of Toronto as a MD candidate for promotion 2021. He collaborated with his supervisor, Dr Catherine Maurice, on several projects including manuscript redaction, database configuration, development of teaching tools and world health risk prevention. Most recently, Kiran collaborated with “Medicines Sans Frontiers/Doctors Without Borders” for the configuration and implementation of an adaptable template, created to improve the communication between MSF physicians on the ground and international consultants. He developed an interest in Neuro-Oncology and collaborated to the redaction of several case reports and manuscripts, aiming at raising awareness about unusual case scenarios in Neuro-Oncology.

 

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In medicine, we are trained to consider a common denominator in a unicist scenario to account for several concomitant symptoms, especially in young patients. Patients diagnosed with either neurologic or oncologic conditions are prone to various comorbidities resulting from their initial diagnosis. Even in the case of young adults, we need to investigate a broader range of possibilities. We present the case of a young man in his early 30s, diagnosed and treated several years prior for a low-grade glioma (primary brain tumor), consulting for seizure recurrence. The main Ambition of seizures initially when his oligodendroglioma was first diagnosed however the tumor is stable on imaging for several years. Three different seizure types are documented in detail. Even if the presence of a low-grade glioma could explain by itself the seizure recurrence, the thorough symptom description and evolution lead to a different hypothesis. This case emphasizes the importance of a good clinical history and research of pertinent details in neuro-oncology patients to reach a prompt and accurate diagnosis. This case describes how three independent “seizure types” surprisingly occurred in a single patient. We threw light on three concomitant etiologies: Glioma-related seizures, pseudo-seizures and metabolic tonico-clonic generalized seizures resulting from a malignant insulinoma. The goal of this presentation is to trigger interest about the field of neuro-oncology. The patient described signed a written consent, confirming his agreement to have his history presented for academic/teaching purpose.

 

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