Introduction: High-grade gliomas comprise central nervous system (CNS) World Health Organization (WHO) Grade 3 and CNS WHO Grade 4 gliomas. Recurrence is seen in almost all patients who underwent treatment. Recurrent high-grade gliomas have poor prognosis. There are phase two trials that assessed the role of irinotecan and bevacizumab as combination regimen in recurrent High-grade gliomas and showed overall survival (OS) and progression-free survival (PFS) benefit. We did a retrospective analysis of our institutional experience on treating recurrent high-grade gliomas with combination of irinotecan and bevacizumab. Materials and Methods: This was a retrospective analysis including 58 patients treated at our center from January 1, 2010 to December 31, 2020. All patients were diagnosed case of CNS WHO Grade 3 and Grade 4 glioma, who received at least one modality of treatment. All patients received inj. Irinotecan 125 mg/m² intravenous (IV) and inj. Bevacizumab 10 mg/kg IV, every 2 weekly. A base line radiological evaluation has been done with magnetic resonance imaging brain with contrast and repeated every 3 months. Patients have been assessed both for PFS and OS. Results: Median PFS was 6 months (95% confidence interval [CI] 4.395–7.605). Median OS was 8 months (95%CI 5.894–10.106). Six months PFS rate is 49% and 6 months OS is 58%. CNS WHO Grade 3 gliomas responded better to combination therapy as compared with CNS WHO Grade 4 gliomas. Conclusion: Combination of Bevacizumab and Irinotecan is well tolerated and improves OS and PFS in patients with recurrent high-grade gliomas. The effect of combination systemic therapy is more evident in CNS WHO Grade 3 gliomas as compared with glioblastoma multiforme.

Inflammatory myofibroblastic tumors (IMTs) are rare tumors of mesenchymal origin, which infrequently involve the central nervous system. Neuroradiological features are nonspecific and they can mimic other tumor-like intracranial lesions. Local recurrence is rare and has been associated with a mutation in the anaplastic lymphoma kinase (ALK) gene. We report a case of recurrent meningeal IMT 15 years after complete resection, without carrying the ALK mutation. This case emphasizes the need to consider IMT in the differential diagnosis as well as the possibility of a late recurrence, suggesting a need for a long-term follow-up and surveillance imaging.

Meningiomas rarely exhibit cystic lesions with mural nodules and may be misdiagnosed as intraparenchymal cystic tumors. We herein present a 52-year-old man with amulti-locilar cystic lesion with heterogeneous enhancement in the right frontotemporal lobe accompanied by peritumoral brain edema. Differential diagnoses included low-grade gliomas and cystic meningioma. The patient underwent right frontotemporal craniotomy and near-total excision of the tumor. Intraoperatively tumor is cystic and firm inconsistency with no clear plane of dissection between tumor and brain parenchyma. Histopathological examination revealed grade 2 atypical meningioma