707 - Rehabilitation Outcomes in DICER1 Intracranial Sarcomas: A Case Report

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

AP

Avani Patel, MD

Resident Physician
Shirley Ryan Ability Lab
Chicago, Illinois, United States

Co-Author(s)

SS

Samman Shahpar, MD

Attending Physician
Shirley Ryan Ability Lab
Chicago, Illinois, United States

Submitter(s)

AP

Avani Patel, MD

Shirley Ryan Ability Lab
Chicago, Illinois, United States

Case Diagnosis: DICER1-associated primary intracranial sarcoma in an adolescent male with postoperative stroke and complex oncologic course.

Case Description: An 18-year-old male with autism spectrum disorder presented with new-onset generalized tonic-clonic seizures. MRI revealed a 3 cm left parietal mass. Following a second seizure, he underwent emergent decompressive craniotomy with tumor resection. Postoperatively, he developed a left thalamocapsular infarct and multifocal hemorrhages, resulting in right-sided hemiparesis, dysphagia, and respiratory failure. Pathology confirmed DICER1-mutant intracranial sarcoma. Germline testing, performed earlier due to family history, revealed a pathogenic DICER1 mutation. The patient underwent ICE chemotherapy and was admitted to acute inpatient rehabilitation (AIR) four times between treatment cycles. On initial AIR admission, he required moderate-to-maximum assistance for ADLs and mobility. Over two months, he achieved significant gains: ambulating 150 feet with minimal assist, performing transfers and self-care with improved independence, and showing marked recovery from Broca’s aphasia. SLP, OT, and PT interventions were critical to progress across communication, mobility, and ADL domains.

Discussions: DICER1-mutant intracranial sarcomas are rare, high-grade pediatric CNS tumors with aggressive clinical courses. Despite the intensity of treatment, literature on rehabilitation outcomes remains limited. This case highlights AIR’s critical role in preserving and enhancing function during active oncologic treatment. Rehabilitation planning was complicated by ongoing chemotherapy, postoperative stroke, and medical complications (e.g., DVT, pneumonia), yet interdisciplinary coordination allowed sustained functional progress. The case also underscores a broader need for standardized rehabilitation guidelines and outcome measures in pediatric neuro-oncology.

Conclusions: This case demonstrates that early, coordinated AIR can yield substantial functional gains—even amid complex oncologic care—in patients with DICER1-associated sarcoma. Systematic research into rehab timing, outcome tracking, and care integration is essential to improving survivorship and quality of life in this rare and vulnerable population.