title: Durable response of intracranial cellular hemangioma to bevacizumab and temozolomide.
abstract: Cellular hemangioma is a subtype of hemangioma that is associated with cellular immaturity and the potential for recurrence. Intracranial location of these lesions is extremely rare, and definitive treatment often requires radical neurosurgical resection. The authors report a case of a 12-year-old boy with a subtemporal cellular hemangioma. He underwent gross-total resection of the tumor, but within 1.5 months the tumor recurred, necessitating a second resection. Because of its proximity to vascular structures, only subtotal resection was possible. Repeat MRI 1 month after the second surgery showed significant tumor recurrence. Given the tumor's demonstrated capacity for recurrence and its proximity to the vein of Labbé and sigmoid sinus, further resection was not indicated. In an effort to limit radiation therapy for this young patient, treatment with bevacizumab and temozolomide was chosen and achieved a complete response that has proven durable for 36 months after cessation of therapy. This is the first report of the successful use of chemotherapy to treat an intracranial hemangioma, a rare condition with limited therapeutic options.
authors.affiliation: Department of Pediatrics, Children’s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA.
authors.forename: Kee Kiat
authors.initials: KK
authors.lastname: Yeo
authors.forename: Elena
authors.initials: E
authors.lastname: Puscasiu
authors.forename: Robert F
authors.initials: RF
authors.lastname: Keating
authors.forename: Brian R
authors.initials: BR
authors.lastname: Rood
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006261:Headache / Q000209:etiology; D018324:Hemangioma, Capillary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009325:Nausea / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D000077204:Temozolomide; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003606:Dacarbazine; D000077204:Temozolomide