J Korean Neurosurg Soc.  2001 Jul;30(7):934-938.

The Effect of Intraventricular Methotrexate in a Patient of Disseminated Anaplastic Oligodendroglioma: Case Report

• Kim SD
• Chung YG
• Kim SH
• Lim DJ
• Cho TH
• Lee HG
• Suh JK
• Lee KC

Abstract

Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.

Keyword

Anaplastic oligodendroglioma; Intraventricular; Methotrexate

MeSH Terms

Adult
Diagnosis
Diplopia
Drug Therapy
Follow-Up Studies
Glioma
Headache
Humans
Lomustine
Magnetic Resonance Imaging
Male
Methotrexate*
Oligodendroglioma*
Procarbazine
Radiotherapy
Vincristine
Lomustine
Methotrexate
Procarbazine
Vincristine