Objective:

To highlight the recurrence of neurological and endocrine symptoms following radiotherapy in a brainstem glioma patient and emphasize the importance of long-term multidisciplinary follow-up in managing post-treatment complications.

Background:

Brainstem gliomas are rare, accounting for 0.5–2 cases per 100,000 individuals. Due to their critical location, surgical resection is often unfeasible, making radiotherapy the primary treatment. However, recurrence of symptoms post-radiotherapy remains a major clinical challenge, which may result from tumor progression, radiation-induced injury, or hormonal dysfunction involving the hypothalamic-pituitary axis. This case illustrates such recurrence and the need for holistic patient management.

Design/Methods:

This is a descriptive case report of a 30-year-old male who presented one year after completing radiotherapy for brainstem glioma at Shaukat Khanum Memorial Cancer Hospital, Peshawar. Clinical evaluation, neuroimaging, and endocrine assessment were used to identify possible causes of recurrent symptoms including headache, vertigo, transient vision loss, and reduced libido.

Results:

MRI confirmed persistent brainstem glioma without clear metastasis. The recurrence of symptoms raised concerns of tumor progression or radiation-induced damage. Endocrine dysfunction was suspected based on weight gain and hormonal symptoms. The patient was referred for multidisciplinary care involving neurology, endocrinology, and oncology for further evaluation and management.

Conclusions:

This case underscores the importance of longterm follow up and multidisciplinary care in managing brainstem glioma patients post radiotherapy. Addressing medical, psychological, and socioeconomic challenges is crucial for optimizing patient outcomes.