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.
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