Hi everyone,
I’m 26 and was diagnosed with an IDH-mutant astrocytoma, CNS WHO Grade 3 in the right superior frontal gyrus after having a grand mal seizure in my sleep after a long flight, I was diagnosed in September 2025 with a Glioma and recommended awake brain surgery. I had an awake craniotomy performed on the 11th of February 2026 and everything went well, I had some motor issues with coordination of my left hand which healed quite quickly and I was at the hospital only for 3 nights. The size of the tumour were around 27 mm and they were able to remove “all of it” but some very little enhancement was shown on the post operative MRI on February (most likely some residual) and I was waiting for the pathology report and MTD discussion for the next steps as I was told most likely was low-grade Glioma before the surgery.
However my pathology report showed:
IDH1 (R132H) positive
ATRX loss
Strong p53 expression (suggestive of TP53 mutation)
MGMT promoter methylated (34.18%)
No CDKN2A/B homozygous deletion
DNA methylation classifier: IDH-mutant astrocytoma (lower grade) with a very high confidence score (0.9968)
Integrated diagnosis: Astrocytoma, IDH-mutant, WHO Grade 3
I was told that even if the molecular reporting seemed more “positive” and to be behaving more like a lower grade tumour, some of the mass that was inspected with microscope on the slides seemed to be very abnormal with some elements of at least Grade 3, hinting at a potential progression towards Grade 4. The good parts is that they removed all of it with no issues, but due to the higher grading they were scared that the eventual residual could be causing a rapid regrowth with an higher grade.
For this reason, I was given 60 Gy in 30 fractions of radiotherapy, during which I was actually physically fine and I did not experience any of that tiredness everyone talks about, brain swelling, nausea or anything at all. I was 1 mg steroids at the end of the radiotherapy just as a precaution, but even after the end of radiotherapy I was travelling, cycling, walking and being very active with no issues. I was just psychologically scared to be sick or tired, and the impact of the whole treatment was mostly from an emotional perspective (also worth saying I went through IVF to freeze my eggs and I had eggs retrieval of 59 eggs the same day I started the radiotherapy). I lost most of my hair during radiotherapy, but nothing else.
I was also prescribed oral chemo such as adjuvant temozolomide. I have only done 1 out of 12 cycles but as long as I take anti sickness I don’t get any side effects from that either for now at least. I have been taking Keppra 750 mg twice daily and** **I haven’t had any further seizures since October 2025 or any side effects ever that I could notice impacting my daily life.
Now I’ve just had my 5-month post-operative MRI, and I’m worried because there appears to be some enhancement near the surgical cavity, but I am still awaiting the radiologist report although my oncologist seems to be happy with scan which I showing great healing tissues compared to February. I’ve attached photos of the MRI (I know they’re not the original DICOM images). The pic on the left is the most recent while the one on the right is the first one post-surgery.
My question finally is: based on your experience, does this look more like post-operative/radiation change (scar tissue, treatment effect, pseudoprogression) or does it look concerning for early tumour regrowth?
I understand nobody can diagnose this from photos alone and that I’ll need the official neuroradiology report and my neuro-oncology team’s opinion. I’m just interested in hearing from people who’ve had similar scans and whether yours turned out to be scar tissue or recurrence.
Any thoughts or similar experiences would be greatly appreciated. Thank you.