title: Relapse and metastasis of atypical teratoid/rhabdoid tumor in a boy with neurofibromatosis type 1 treated with recombinant human growth hormone.
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.
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tornese
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Faleschini
authors.affiliation: University of Trieste, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Matarazzo
authors.affiliation: University of Trieste, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bibalo
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Giulio Andrea
authors.initials: GA
authors.lastname: Zanazzo
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rabusin
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Floriana
authors.initials: F
authors.lastname: Zennaro
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ventura
mesh_terms: D020295:Brain Stem Neoplasms / Q000473:pathology / Q000556:secondary*; D002528:Cerebellar Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D019382:Human Growth Hormone / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009456:Neurofibromatosis 1 / Q000188:drug therapy* / Q000473:pathology; D011994:Recombinant Proteins / Q000009:adverse effects; D012008:Recurrence; D018335:Rhabdoid Tumor / Q000188:drug therapy* / Q000473:pathology; D012307:Risk Factors; D013724:Teratoma / Q000188:drug therapy* / Q000473:pathology
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone