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.
Keywords
NF1 - AT/RT - recurrence - brain tumor - rhGH
