Spontaneous regression of brain tumors in children: case report and literature review

Abstract

Introduction: They are defined as space-occupying lesions that present radiological characteristics of tumors and that resolve spontaneously during radiological follow-up. Spontaneous regression of tumors is a rare phenomenon, with a regression rate in malignant tumors of 1/60,000 to 100,000 patients. Materials and Methods: An 11-year-old female with polydipsia, polyuria, 5 kg weight loss, ataxia, headache, vision loss, and diabetes insipidus. CT with chiasm-dependent tumor occupying the interpenduncular cistern, displacing the hypothalamus ventrally. Results: An excisional biopsy was performed using a pterional approach, microsurgical resection + ultrasonic aspiration, during the trans-surgical procedure thickening of the chiasm and optic nerves was found. WHO Grade I Pilocytic Astocytoma was reported. In the two-year follow-up with magnetic resonance imaging of the brain, we observed complete tumor regression. Discussion: Partial cytoreduction of the tumor, biopsy, radiotherapy or chemotherapy play a role in the initiation of tumor apoptosis. Surgical trauma favorably alters the biological activity of the tumor and the immunological status of the host. Conclusions: The mechanisms of spontaneous regression and spontaneous involution of residual tumor after surgery are not known. Apoptosis may be the common denominator, possible mechanisms include immunological, genetic and biological factors.