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Front. Oncol. | doi: 10.3389/fonc.2019.01288

Corticosteroid-Induced Regression of Glioblastoma: A Radiographic Conundrum

 Joshua A. Cuoco1*, Brendan J. Klein1, Christopher M. Busch1, Evin L. Guilliams1, Adeolu L. Olasunkanmi1 and John J. Entwistle1
  • 1Carilion Clinic, United States

Corticosteroid-induced regression of lesion contrast enhancement on imaging studies is most commonly appreciated with primary central nervous system lymphoma; however, although exceedingly rare, a limited number of primary and metastatic intracranial lesions have been reported to exhibit similar radiographic changes subsequent to corticosteroid therapy. To date, there have been six cases of glioblastoma reported to exhibit such changes. Lesion transformation on repeat imaging after the initiation of steroids represents a diagnostic dilemma for clinicians when attempting to differentiate between a diagnosis of glioblastoma and lymphoma. Stereotactic biopsy may be inadvertently postponed due to high clinical suspicion for steroid-induced cytotoxicity traditionally seen with lymphomatous cells. To highlight this radiographic conundrum, we present a rare case of corticosteroid-induced regression of glioblastoma and discuss the relevant literature. To our knowledge, this is the first case report to describe the molecular profile of a glioblastoma that underwent corticosteroid-induced regression.

Keywords: Glioblastoma, Astrocytoma, brain tumor, corticosteroid, Dexamethasone, regression, vanishing tumor, Neuro-Oncology

Received: 31 Jul 2019; Accepted: 06 Nov 2019.

Copyright: © 2019 Cuoco, Klein, Busch, Guilliams, Olasunkanmi and Entwistle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Joshua A. Cuoco, Carilion Clinic, Roanoke, United States, jacuoco@carilionclinic.org