16/08/2026
đ§ A Remarkable Radiological Response in Recurrent Grade 4 Astrocytoma
Sometimes, a 3-month interval between two MRI scans tells a powerful story.
Sharing an encouraging treatment response in a young patient with bifrontal IDH-mutant Astrocytoma, CNS WHO Grade 4, involving the corpus callosum.
đš Initial treatment: Gross total resection followed by 60 Gy/30 fractions with concurrent temozolomide, then 6 cycles of adjuvant temozolomide.
đš May 2026: MRI/MRS demonstrated recurrent bifrontal disease with invasion of the genu and proximal body of the corpus callosum.
đš With recurrent disease, Bevacizumab + Carmustine was initiated on 19 May 2026.
đ May 2026 âĄī¸ August 2026
The side-by-side MRI images demonstrate a striking reduction in the previously extensive enhancing bifrontal abnormality and associated mass effect after approximately three months of salvage treatment.
The clinical assessment recorded an âexcellent response in view of mass lesions,â with a residual issue of left frontal convexity subdural collection requiring separate evaluation.
The molecular profile makes this case particularly challenging: IDH1-mutant, ATRX loss, TP53/PTEN alterations, CDKN2A/B homozygous deletion, MGMT unmethylated and 1p/19q non-codeleted disease.
đĄ The message: Even in aggressive recurrent high-grade glioma, carefully selected salvage therapy can sometimes achieve a dramatic radiological response and meaningful disease control.
Three months. Two MRIs. One very encouraging response.
