Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas—possible role of Cannabis inhalation
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Spontaneous regression of pilocytic astrocytoma after incomplete resection is well recognized, especially for cerebellar and optic pathway tumors, and tumors associated with Neurofibromatosis type-1 (NF1). The purpose of this report is to document spontaneous regression of pilocytic astrocytomas of the septum pellucidum and to discuss the possible role of cannabis in promoting regression.
We report two children with septum pellucidum/forniceal pilocytic astrocytoma (PA) tumors in the absence of NF-1, who underwent craniotomy and subtotal excision, leaving behind a small residual in each case. During Magnetic Resonance Imaging (MRI) surveillance in the first three years, one case was dormant and the other showed slight increase in size, followed by clear regression of both residual tumors over the following 3-year period. Neither patient received any conventional adjuvant treatment. The tumors regressed over the same period of time that cannabis was consumed via inhalation, raising the possibility that the cannabis played a role in the tumor regression.
We advise caution against instituting adjuvant therapy or further aggressive surgery for small residual PAs, especially in eloquent locations, even if there appears to be slight progression, since regression may occur later. Further research may be appropriate to elucidate the increasingly recognized effect of cannabis/cannabinoids on gliomas.
KeywordsPilocytic astrocytoma Septum pellucidum Fornix Tumor regression Cannabinoids Cannabis
No financial relationships exist that are relevant to this study.
Conflict of interest statement
The authors would like to declare that no conflict of interest exists.
The University of British Columbia Institutional Review Board does not require application for formal ethics approval for case reports involving three or fewer subjects. All participating subjects provided verbal and email consent prior to participation in this study, and all research activities were performed in accordance with the ethical standards of good clinical practice as outlined in the 1964 Declaration of Helsinki.
- 1.Abdelrahim M, Newman K, Vanderlaag K, Samudio I, Safe S (2006) 3, 3′-diindolylmethane (DIM) and its derivatives induce apoptosis in pancreatic cancer cells through endoplasmic reticulum stress-dependent upregulation of DR5. Carcinogenesis 27(4):717–728. doi: 10.1093/carcin/bgi270 PubMedCrossRefGoogle Scholar
- 11.Carracedo A, Lorente M, Egia A, Blazquez C, Garcia S, Giroux V, Malicet C, Villuendas R, Gironella M, Gonzalez-Feria L, Piris MA, Iovanna JL, Guzman M, Velasco G (2006) The stress-regulated protein p8 mediates cannabinoid-induced apoptosis of tumor cells. Cancer Cell 9(4):301–312. doi: 10.1016/j.ccr.2006.03.005 PubMedCrossRefGoogle Scholar
- 24.Gustafsson K, Christensson B, Sander B, Flygare J (2006) Cannabinoid receptor-mediated apoptosis induced by R(+)-methanandamide and Win55, 212–2 is associated with ceramide accumulation and p38 activation in mantle cell lymphoma. Mol Pharmacol 70(5):1612–1620. doi: 10.1124/mol.106.025981 PubMedCrossRefGoogle Scholar
- 26.Guzman M, Duarte MJ, Blazquez C, Ravina J, Rosa MC, Galve-Roperh I, Sanchez C, Velasco G, Gonzalez-Feria L (2006) A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. Br J Cancer 95(2):197–203. doi: 10.1038/sj.bjc.6603236 PubMedCrossRefGoogle Scholar
- 30.Huang K, Whelan EA, Ruder AM, Ward EM, Deddens JA, Davis-King KE, Carreon T, Waters MA, Butler MA, Calvert GM, Schulte PA, Zivkovich Z, Heineman EF, Mandel JS, Morton RF, Reding DJ, Rosenman KD (2004) Reproductive factors and risk of glioma in women. Canc Epidemiol Biomarkers Prev 13(10):1583–1588Google Scholar
- 34.Ligresti A, Moriello AS, Starowicz K, Matias I, Pisanti S, De Petrocellis L, Laezza C, Portella G, Bifulco M, Di Marzo V (2006) Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma. J Pharmacol Exp Ther 318(3):1375–1387. doi: 10.1124/jpet.106.105247 PubMedCrossRefGoogle Scholar
- 37.Palma L, Celli P, Mariottini A (2004) Long-term follow-up of childhood cerebellar astrocytomas after incomplete resection with particular reference to arrested growth or spontaneous tumour regression. Acta Neurochir (Wien) 146(6):581–588. doi: 10.1007/s00701-004-0257-9, discussion 588CrossRefGoogle Scholar
- 43.Sarfaraz S, Afaq F, Adhami VM, Malik A, Mukhtar H (2006) Cannabinoid receptor agonist-induced apoptosis of human prostate cancer cells LNCaP proceeds through sustained activation of ERK1/2 leading to G1 cell cycle arrest. J Biol Chem 281(51):39480–39491. doi: 10.1074/jbc.M603495200 PubMedCrossRefGoogle Scholar
- 53.Wigertz A, Lonn S, Hall P, Auvinen A, Christensen HC, Johansen C, Klaeboe L, Salminen T, Schoemaker MJ, Swerdlow AJ, Tynes T, Feychting M (2008) Reproductive factors and risk of meningioma and glioma. Canc Epidemiol Biomarkers Prev 17(10):2663–2670. doi: 10.1158/1055-9965.EPI-08-0406 CrossRefGoogle Scholar