Abstract

As well known, diffuse infiltrative pontine glioma (DIPG)-despite all available treatment modalities- carries a dismal prognosis with a mean survival of around one year [1]. A four year old boy was referred to me with a radiological diagnosis of DIPG. He was irradiated and a ventriculoperitoneal shunt (VPs) was inserted in a health facility in Europe. On admission (seven months after the diagnosis), patient was tracheostomized, conscious, quariparetic and with bilateral abducens and lower cranial nerve paresis. I decided to operate on the patient in order to debulk the necrotic pontine mass and to verify the radiological diagnosis histopathologically. Additionally, I planned to co-culture the tumoral cells with the natural killer (NK) cells isolated from the peripheral venous blood to investigate the immunization and potentiation of autologous NK cells against glioma cells in vitro after the ethical committee approval was obtained from the Istanbul Aydin University. In January 2019, pontine mass was partially removed via telo-velar approach under neurophysiological monitorization with no additional post op deficits and the unilateral abducens nerve recovery. Tumor specimens were sent to the tissue culture labs and the cell culture procedures were carried out meticulously. Meanwhile, routine histopathological evaluation reported the pontine lesion as DIPG (Grade 4 astrocytoma) officially.