Case of Brain Tumour after treatment for Ataxia Telangiectasia
A 13-year-old boy presented with the complaint of recurrent headaches. Examination revealed significant neurological deficits affecting his motor function. The severity of the deficit bound him to a wheelchair and he was also unable to walk. However, his intellectual functioning was normal.
Brain Tumour: History and Investigations
The doctors had been treating the patient for Ataxia Telangiectasia. This disease primarily affects the nervous system, causing ataxia in the early years of life. Additionally, it affects the immune system that causes a decrease in the production of antibodies. The doctors were treating him with intravenous immunoglobulin for it.
Four years prior to this presentation, the child’s guardians started the child on another treatment regimen, which was not in the knowledge of the doctors. This treatment regimen was administered 3 times in the past four years and the patient was injected with foetal neural stem cells.
The doctors performed an MRI of the brain and spinal Cord to diagnose the underlying cause of the headache. The reports revealed two lesions, one compressing the brain stem (a vital organ controlling heart rate and breathing), and the other lesion at the cauda equina (collection of nerve roots at the end of the spinal cord).
The doctors surgically removed the tumours. In addition, during the surgery, the doctors also found some smaller lesions termed “satellite lesions”. They were located near the tumour at the cauda equina. The satellite lesions were also removed during the surgery.
The patient remained stable postoperatively. Moreover, the doctors asked the patient to follow up regularly. During this time, the doctors observed slight growth in the tumour compressing the brain stem. However, the spinal cord tumour did not increase in size.
The doctors continued to follow up with the patient to prevent his condition from deteriorating.
Did the stem cells play a role?
The doctors found that the origin of the brain tumours was within the vicinity of the injection sites where the neural stem cells were administered. This prompted them to do genetic sequencing of the brain tumour cells. As suspected, the cells depicted a non-host origin. Hence confirming the doctor’s speculation of the brain tumour originating from the donor stem cells.