Robert Wood Johnson University Hospital
New Brunswick • Somerset

First Pediatric Brainstem Tumor Treated with Laser Ablation

The parents of 10 year-old Madison Beggs were told there was no hope. Their daughter had an inoperable brain tumor. But a new procedure changed everything. Madison, a Robert Wood Johnson patient, became the first person to undergo pediatric brainstem tumor ablation.


10 year-old Madison Beggs became the first person to undergo pediatric brainstem tumor ablation. (Photo credit: John O'Boyle/The Star-Ledger)

"Madison presented with numbness and difficulty moving the left side of her face, which was thought to be related to Bell's palsy.

When it progressed to the hand and foot, an MRI showed a mass in her brain," says Rachana Tyagi, MD, assistant professor of surgery at Rutgers-Robert Wood Johnson Medical Schooland director of pediatric neurosurgery at The Bristol-Meyers Squibb Children's Hospital at Robert Wood Johnson University Hospital.

"It took just over two weeks to confirm the diagnosis of a rare and until now, inoperable and fatal brain tumor."

The highly aggressive tumor was growing from the brain stem and considered too risky for traditional surgery. Loss of sight, movement and speech were all possible complications.

Dr. Tyagi recommended a consult with her colleague Shabbar F. Danish, MD, assistant professor of surgery at Rutgers-Robert Wood Johnson Medical School and director of the Stereotactic and Functional Neurosurgery Program at the medical school and Robert Wood Johnson University Hospital.

Dr. Danish had recently performed laser-ablation surgery on an intracranial ependymoma, a tumor that grows from the cells that line the ventricles in the brain.

 

"We felt that the laser gave us a chance at treating a tumor that is traditionally inaccessible," explains Dr. Danish. "In doing so, we might give Madison hope for controlling her tumor."

Laser ablation involves placing a laser directly into the tumor and then guiding the laser to perform thermal ablation, or killing it with heat, while leaving the surrounding areas of the brain untouched. The entry hole that is made through the skull is about the size of the end of a pen and requires just one stitch and a small bandage following the delicate procedure.

"It was a very hard decision, but I had faith in the doctors and in God," explains her mother, Mae Beggs. "The whole family wanted her to have the laser ablation procedure but I was skeptical because there were no known long term effects. I the end, I made the decision to do this procedure because we wanted what was best for her always."

Madison, who enjoys school, currently receives her lessons at home and is anxious to return to Land of Pines School in Howell, NJ, and to Girl Scouts and soccer.

"The post-ablation MRI shows no evidence of tumor progression at this point, so we believe she has a real chance at a cure," reports Dr. Danish.

Madison will receive radiation to the brain and spine for approximately 6 weeks to aggressively combat a potential recurrence of the tumor, along with a total of 6 months of chemotherapy.

"Madison's treatment is going extremely well; there are no issues," reports Dr. Tyagi. "Madison is the perfect patient."

Laser ablation therapy is a new FDA-cleared product designed by Visualase, Inc.

Dr. Tyagi and Dr. Danish are members of The Robert Wood Johnson Medical Group, Rutgers-Robert Wood Johnson Medical School's multi-disciplinary faculty practice with approximately 500 physicians encompassing more than 200 sub-specialties, who have privileges at Robert Wood Johnson University Hospital.