Saturday, July 23, 2011

Ependymoma,complete resolution.

Case summary:
This, 26 years nice man from Karachi had undergone insertion of VP shunt on right side on November 22, 2010 on radio diagnosis of heterogeneous enhancing solid cum cystic mass in posterior fossa in fourth ventricle causing hydrocephalus. This was diagnosed when patient had presented with severe headache on and off associated with vomiting worst since last month and blurred vision since one month.

On referral, he had presented some improvement in headache and vomiting and significant improvement in blurring of vision. Clinical examination had revealed no obvious neurologic deficit. MRI brain spectroscopy had revealed markedly elevated Choline levels up to 399. Patient has referred us for the management with GKSRS.  Risk of GKSRS explained all in Urdu along with requirement of strict follow up. These agreed upon wished to proceed. He had treatment with following prescription,

     12Gy @ 50%
   18.6 cm³

Multiple isocenters with 18, 14 & 8 mm collimator used in APS mode. He had discharged on tapering doses of Dexamethasone and advised follow up after 3 months

Follow up at 3 months showed almost complete resolution of the tumor.

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