Brainstem Expansive Lesion Suggestive of Glioma in a Renal Transplant Patient

Introduction: Immunosuppression following kidney transplantation is associated with a significantly increased risk of mortality and the development of neoplasms, especially due to the continuous use of immunosuppressants, which increase susceptibility to opportunistic infections and the development of tumors. Among the possible neurological complications in this group, glial tumors of the brainstem represent a rare and difficult-to-diagnose condition, with a high rate of malignancy and a guarded prognosis, whose therapeutic management is limited and often palliative. Objective: To report a case of an immunosuppressed patient with a kidney transplant who developed an expansive lesion in the brainstem suggestive of glioma, treated empirically with radiotherapy due to the infeasibility of biopsy. Methods: Descriptive observational study and literature review in the PubMed and SciELO databases, covering the past 20 years. Results: The patient showed progressive clinical improvement and a favorable radiological response to empirical radiotherapy, with no metastases or tumor recurrence identified in the follow-up of the last 4 years. Conclusion: Despite the rarity and poor prognosis of brainstem gliomas in immunosuppressed patients, this case demonstrates that empirical radiotherapy, when biopsy is not feasible, can be considered an alternative treatment and presents favorable results. The report also reinforces the need for neurological surveillance in transplant recipients and expands knowledge about neoplastic complications of the central nervous system in the context of prolonged immunosuppression.