Incidental low grade glioma in young female: An indolent lesion? A case report and a literature review

Objective: The wide use of brain MRI has led to an increased diagnosis of incidental low-grade gliomas (LGGs). There is no consensus regarding the surgical treatment of incidental LGGs, nor even when we deal with a young woman who wants to plan a pregnancy. We performed a literature review on the topic of cognitive testing and pregnancy in LGGs. Results on the patients' cognitive status are poorly addressed: if, after surgery, neuropsychological deficits were to arise, this would greatly complicate the management of a child by a mother who is an oncological patient, and, moreover, has developed cognitive alterations that may compromise the abilities to look after a baby. We also report the case of a 30-years old woman with a diagnosis of incidental LGG who underwent a first surgery for a right-frontal oligodendroglioma Methods: The patient underwent two awake surgeries and in both performed the Real Time Neuropsychological Testing (RTNT). We acquired clinical and MRI data. This paper also reports a literature review on the topic of cognitive testing and pregnancy in LGGs highlighting a lack of adequate data about this issue. Results: No deterioration of neuropsychological performances was documented during surgery. During the follow-up, she became pregnant and, despite an increased growth rate of the lesion, she did not accuse any symptom or sign of evolution in high-grade glioma (HGG). She underwent a second awake surgery with RTNT. Performance was maintained within the normal range. Conclusions: We concluded that, in our experience, pregnancy could induce an increased growth rate of LGG, not influencing the prognosis.