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Neuro-Oncology 2005 7(1):97-100; doi:10.1215/S1152851704000560
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© 2005 by the Society forNeuro-Oncology

Neoadjuvant temozolomide followed by complete resection of a 1p- and19q-deleted anaplastic oligoastrocytoma: Case study

Alfredo D. Voloschin, David N. Louis, Garth R. Cosgrove and Tracy T. Batchelor2

Departments of Neurology (A.D.V., T.T.B.), Pathology (D.N.L.), and Neurosurgery (D.N.L., G.R.C.) and Cancer Center (D.N.L.), Massachusetts General Hospital andHarvard Medical School, Boston, MA 02114, USA

2 Address correspondence to Tracy Batchelor, Brain Tumor Center, Cox 315,Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA(tbatchelor{at}partners.org).


  Abstract

A 38-year-old woman presented with an infiltrative tumor of the rightfrontal lobe and genu of the corpus callosum that was deemed only partiallyresectable. A stereotactic biopsy was performed, which revealed a rightfrontal oligoastrocytoma that had some anaplastic features as well as allelicloss of chromosome arms 1p and 19q. The patient was treated with temozolomidefor 24 months. The partial response of the tumor to chemotherapy rendered thelesion amenable to gross total resection, which was performed subsequently.The patient remains alive and well without evidence of recurrence 7 monthsafter resection and 48 months after initial diag-nosis. Thus, preoperativechemotherapy decreased tumor mass to a degree that subsequently enabled agross total resection. This treatment strategy, although common in thetreatment of other solid tumors, is rarely utilized in adult neuro-oncologyand raises another potential role for chromosome testing in oligodendroglialtumor management.

Received June 2, 2004; Accepted August 25, 2004


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