Combined multiple surgical intervention and chemotherapy for multicentric WHO grade II glioma : a long-term follow-up study.

Abstract

Multicentric WHO grade II gliomas constitute a rare entity. Their pathogenesis and treatment are still a matter of debate. We present a 23 year-old female with two synchronous but separate WHO grade II oligodendrogliomas in the temporal and frontal lobes. The two lesions showed independent evolution, requiring surgical treatment at different stages. For a recurrence of the disease at the frontal site, a temozolomide chemotherapy regimen was commenced with a favourable response. After 7 years follow-up, the patient is free of neurological symptoms and enjoys a normal life. The problems concerning the pathophysiology, diagnosis and treatment of this condition are discussed. On the basis of our results, we suggest that an active therapeutic strategy, by combining multiple surgical procedures and complementary treatment, should be systematically considered in multicentric WHO grade II gliomas, as in similar unifocal neoplasms.