尽管经过多年的研究，4 级神经胶质瘤的护理标准 (SOC) 治疗在过去 20 年中几乎保持不变。自体肿瘤裂解物负载树突状细胞疫苗接种 (DCVax-L) 是一种新型免疫疗法，在 3 期试验中已证明具有显着的生存益处。 一名 34 岁男性出现头晕发作，随后被诊断为额叶大-岛颞叶肿瘤，可能是高级别肿瘤。他在睡梦中接受了开颅手术，在额叶和杏仁核中发现了残留的肿瘤。肿瘤组织病理学报告为异柠檬酸脱氢酶 (IDH) 突变甲基化 4 级星形细胞瘤。他接受了 SOC 治疗以及 DCVax-L 疗程。监测影像显示额叶残余肿瘤发生囊性转变，随后体积缩小；杏仁核的残余部分已经完全消退。该患者临床状况良好，并已恢复到术前的功能。作者报告了一名 4 级星形细胞瘤患者，除了 SOC 辅助治疗外，还接受了 DCVax-L 治疗。肿瘤消退的模式和程度对于单独辅助 SOC 治疗所观察到或预期的情况来说是非常不寻常和非典型的。将 DCVax-L 添加到 SOC 中为治疗这种疑难疾病开辟了新途径。 https://thejns.org/doi/10.3171/CASE24112。

Despite years of research, the standard of care (SOC) treatment for grade 4 glioma has remained virtually unchanged for the last 2 decades. Autologous tumor lysate-loaded dendritic cell vaccination (DCVax-L), a novel immunotherapy, has demonstrated a significant survival benefit in a phase 3 trial.A 34-year-old male presented with episodes of lightheadedness and was subsequently diagnosed with a large fronto-insulo-temporal tumor, likely to be high grade. He underwent an asleep craniotomy for debulking, with a residual tumor noted in the frontal lobe and amygdala. Tumor histopathology was reported as isocitrate dehydrogenase (IDH) mutant methylated grade 4 astrocytoma. He received SOC treatment, alongside a course of DCVax-L. Surveillance imaging showed cystic transformation followed by a reduction in size of the residual tumor in the frontal lobe; the residual in the amygdala had regressed entirely. The patient remained clinically well and had returned to his preoperative functionality.The authors report a patient with grade 4 astrocytoma who received DCVax-L treatment in addition to SOC adjuvant therapy. The pattern and extent of tumor regression are highly unusual and atypical for what is seen or expected with adjuvant SOC treatment alone. The addition of DCVax-L to SOC opens new avenues in the management of this difficult disease. https://thejns.org/doi/10.3171/CASE24112.