Neuropediatrics 2015; 46(02): 126-129
DOI: 10.1055/s-0034-1393706
Short Communications
Georg Thieme Verlag KG Stuttgart · New York

Relapse and Metastasis of Atypical Teratoid/Rhabdoid Tumor in a Boy with Neurofibromatosis Type 1 Treated with Recombinant Human Growth Hormone

Gianluca Tornese
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
2   University of Trieste, Italy
,
Elena Faleschini
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
,
Lorenza Matarazzo
2   University of Trieste, Italy
,
Cristina Bibalo
2   University of Trieste, Italy
,
Giulio Andrea Zanazzo
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
,
Marco Rabusin
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
,
Giorgio Tonini
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
,
Floriana Zennaro
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
,
Alessandro Ventura
1   Institute for Maternal and Child Health - IRCCS “Burlo Garofolo” - Trieste, Italy
2   University of Trieste, Italy
› Author Affiliations
Further Information

Publication History

30 March 2014

14 July 2014

Publication Date:
27 January 2015 (online)

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Abstract

Even though no increased recurrence rate seems to be reported in patients with brain tumors receiving recombinant human growth hormone (rhGH) replacement, in some patients multiple risk factors could put at higher risk for recurrence. In such cases, the decision to start rhGH therapy should be very cautious. A boy with neurofibromatosis type 1 developed an atypical teratoid/rhabdoid tumor (AT/RT) of right cerebellum, treated with surgery, radiotherapy, and chemotherapy. After 3 years of remission, he started rhGH for growth hormone deficiency, having a negative magnetic resonance imaging (MRI) scan. Ten weeks after starting therapy, the boy became symptomatic and MRI showed relapse of AT/RT in the right cerebellum and a new lesion in the brainstem. The boy died of progressive disease. In this case, the connection between AT/RT recurrence and the beginning of rhGH therapy, with a negative pretreatment MRI, cannot be excluded. Additional caution should be used for rhGH in patients with multiple risk factors.

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