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Case Report
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| Unexpected brain atrophy following administration of intratumoral interferon alpha-2b for cystic craniopharyngioma: A case report | ||||||
| Khadiga Elfadil Ahmed Mohammed1, Kellie R Alleyne Mike1, Jeannette Parkes2 | ||||||
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1Senior Resident (FC RadOnc SA), Department of Radiation Oncology in Groote Schuur Hospital, Cape Town, Western Cape, South Africa.
2Head of Radiation Oncology Unit, Consultant Oncologist, Department of Radiation Oncology in Groote Schuur Hospital, Cape Town, Western Cape, South Africa. | ||||||
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| How to cite this article |
| Mohammed KEA, Mike KRA, Parkes J. Unexpected brain atrophy following administration of intratumoral interferon alpha-2b for cystic craniopharyngioma: A case report. International Journal of Case Reports and Images 2013;4(12):719–722. |
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Abstract
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Introduction:
The use of intracystic treatments is relatively new in the treatment of craniopharyngioma and has the potential for decreased morbidity and long-term control in patients with recurrent cysts after radiotherapy as well as delaying radiotherapy treatment in young children. We describe a case in which the therapeutic use of interferon alpha-2b (IFNa-2b) was associated with an adverse effect that has not yet been documented in the medical literature.
Case Report: An eight-year-old boy with a history of a craniopharyngioma was presented with radiological evidence of recurrence. He was first diagnosed at the age of eight months and had undergone repeated subtotal resections. At the age of three, he also received adjuvant radiotherapy after one of these resections. On this presentation of recurrence, a decision was made to offer him intracystic treatment with IFNa-2b. Although the typical pre-treatment leakage test was positive, the planned treatment decision was maintained following extensive multi-disciplinary consult with both local and international teams who advised that any extravasation of IFNa-2b was likely innocuous. During the course of the treatment the patient demonstrated severe lethargy. Two weeks after completing the full course he presented with urinary incontinence, confusion and blood investigations confirmed hypernatremia and hyperthyroidism. Radiologic imaging showed a stable cystic mass, worsening hydrocephalus and extensive brain atrophy when compared with pre-treatment imaging. Conclusion: The potential for brain atrophy with intracystic IFNa-2b has not been documented previously. While we have found no evidence to support a causal association between IFNa-2b administration and neurotoxicity, the implications of such toxicity warrant further investigation and careful observation for similar events in the future. | |
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Keywords:
Craniopharyngioma, Intratumoral interferon alpha, Brain atrophy, Neurotoxicity
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Author Contributions
Khadiga Elfadil Ahmed Mohammed – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Kellie R Alleyne Mike – Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Jeannette Parkes – Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Khadiga Elfadil Ahmed Mohammed et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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