Laser interstitial thermal therapy as a radiation-sparing approach for central nervous system tumors in children with cancer predisposition syndromes: Report of a child with Li-Fraumeni syndrome. Illustrative case Journal Article

   

Authors:	Guadix, S. W.; Pandey, A.; Gundlach, C.; Walsh, M.; Moss, N. S.; Souweidane, M. M.
Article Title:	Laser interstitial thermal therapy as a radiation-sparing approach for central nervous system tumors in children with cancer predisposition syndromes: Report of a child with Li-Fraumeni syndrome. Illustrative case
Abstract:	BACKGROUND Ionizing radiation and alkylating chemotherapies increase secondary malignancy risk in patients with cancer predisposition syndromes (CPSs), such as Li-Fraumeni syndrome. Laser interstitial thermal therapy (LITT) is a minimally invasive ablation technique that has not been associated with mutagenic risks. We describe the case of a child with LFS and a history of treated choroid plexus carcinoma (CPC) who developed a second primary glial tumor that was safely treated with magnetic resonance imaging (MRI)–guided LITT. OBSERVATIONS A 4-year-old male with left parietal World Health Organization grade III CPC associated with a TP53 germline mutation was evaluated. The patient underwent neoadjuvant platinum-based chemotherapy before near-total resection, followed by131I-8H9 immunotherapy and 30 fractions of 54-Gy proton radiotherapy. He remained without evidence of disease for 2 years before developing a slow-growing mass adjacent to the left frontal ventricular horn. Stereotactic biopsy revealed a glial neoplasm. Given the nonsuperficial location and focality of the lesion, MRI-guided LITT was performed for ablative therapy. There were no complications, and 2 years of surveillance revealed continued retraction of the ablated tumor focus andnosubsequentdisease. LESSONS Alternatives to mutagenic therapies for brain tumors should be explored for patients with CPS. LITT paired with imaging surveillance is a logical strategy to ensure durable outcomes and mitigate treatment-related secondary neoplasms. © 2024 The authors.
Keywords:	pediatric; li-fraumeni syndrome; laser interstitial thermal therapy; cancer predisposition; choroid plexus carcinoma
Journal Title:	Journal of Neurosurgery: Case Lessons
Volume:	7
Issue:	6
ISSN:	2694-1902
Publisher:	American Association of Neurological Surgeons
Date Published:	2024-02-05
Start Page:	CASE23595
Language:	English
DOI:	10.3171/case23595
PROVIDER:	scopus
PMCID:	PMC10849145
PUBMED:	38315990
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85184692035&doi=10.3171%2fCASE23595&partnerID=40&md5=94177aafc3db67ea57be776137b28d3b
Notes:	Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/213903