Achievement of three year remission with bevacizumab and irinotecan in recurrent glioblastoma multiforme: a case report

Abstract

A 34-year-old man presented to the hospital with right-sided headache. He was diagnosed with GBM. He underwent resection of the tumor with placement of carmustine impregnated wafers. Then he underwent adjuvant chemotherapy with temozolamide. Before the completion of chemotherapy he had a recurrence. He underwent re-resection with placement of carmustine impregnated wafers. Subsequently he had eighteen cycles of salvage biochemotherapy with bevacizumab and irinotecan. To date, routine MRI scans of the brain have not shown evidence of recurrence. He continues to be in remission three years after treatment with bevacizumab and irinotecan.

Keywords: bevacizumab; irinotecan; recurrent glioblastoma multiforme.

Figure 1.

MRI of brain with gadolinium showing a large right temporoparietal hemorrhagic mass (arrow).

Figure 2.

MRI of brain with gadolinium showing postoperative changes with surgical margin enhancement, edema and/or non-enhancing neoplasm (arrow).

Figure 3.

MRI of brain with gadolinium showing new heterogeneously enhancing lesion adjacent to the surgical bed within the right temporal lobe consistent with recurrent neoplasm (arrow).

Figure 4.

MRI of brain with gadolinium showing postsurgical changes within the right temporal lobe with no significant mass effect or midline shift (arrow).

Figure 5.

MRI of brain with gadolinium showing overall decrease in midline shift and edema with no evidence of recurrence (arrow).