scholarly journals Intraventricular dissemination of the pilocytic astrocytomas in an adult

2020 ◽  
pp. 326-329
Author(s):  
Vijay P. Joshi ◽  
Ashwin Valsangkar ◽  
Satish Nivargi ◽  
Anish Dekhne ◽  
Amit Agrawal
Keyword(s):  
Clinical Significance ◽  
Pilocytic Astrocytoma ◽  
Rapid Progression ◽  
Diagnosis And Management ◽  
Primary Disease ◽  
Pilocytic Astrocytomas ◽  
Disseminated Disease ◽  
Benign Course

Pilocytic astrocytoma (PA) is a subset of gliomas characterized by a benign course with an excellent prognosis and rarely metastasizing or spreading along the neuraxis. We report a case of a 56-year female with intraventricular dissemination of pilocytic astrocytoma in an adult and discuss the clinical significance diagnosis and management including the peculiar pattern of dissemination of the pilocytic astrocytoma. The course of the disseminated disease may not be as good as that of patients with localized recurrence or totally resected primary disease and can vary from rapid progression to prolonged stabilization.

Malignant transformation in benign cerebellar astrocytoma

1978 ◽  
Vol 49 (1) ◽  
pp. 111-118 ◽  
Author(s):  
George M. Kleinman ◽  
William C. Schoene ◽  
Thomas M. Walshe ◽  
Edward P. Richardson
Keyword(s):  
Malignant Transformation ◽  
Pilocytic Astrocytoma ◽  
Partial Removal ◽  
Content Type ◽  
Cerebellar Astrocytoma ◽  
Juvenile Pilocytic Astrocytoma ◽  
Pilocytic Astrocytomas ◽  
Infiltrative Growth Pattern ◽  
Fine Print

✓ The authors give follow-up information on Case 59 of Cushing's 1931 series of cerebellar astrocytomas. The patient died with a malignant cerebellar astrocytoma 48 years after partial removal of a previously benign astrocytoma at the same site. Including the present one, there have been only five reported cases in which this has occurred. Ordinarily, juvenile pilocytic astrocytomas are of extremely benign character, and it is well established that even with incomplete resections patients have survived for years without progression of the tumor. Not all of the cases so reported can be wholly accepted as representing malignant transformation of the tumor, but may instead be instances of recurrence of an inherently benign glioma since the presence of features such as endothelial hyperplasia or nuclear atypicality in a juvenile pilocytic astrocytoma does not warrant its being classified as malignant. Features truly suggestive of malignancy are hypercellularity, frequent mitoses, necrosis, and, in some instances, a diffusely infiltrative growth pattern; all of these features were found in the present case.

scholarly journals Adult patients with supratentorial pilocytic astrocytoma: long-term follow-up of prospective multicenter clinical trial NCCTG-867251 (Alliance)

2015 ◽  
Vol 2 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Paul D. Brown ◽  
S. Keith Anderson ◽  
Xiomara W. Carrero ◽  
Brian P. O'Neill ◽  
Caterina Giannini ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pilocytic Astrocytoma ◽  
Survival Rates ◽  
Prospective Trial ◽  
Subtotal Resection ◽  
Entire Cohort ◽  
Pilocytic Astrocytomas ◽  
Long Term Follow Up

Abstract Background Pilocytic astrocytoma is a rare tumor in adults. This report is of a prospective clinical trial with long-term follow-up. Methods Between 1986 and 1994, 20 eligible adults with supratentorial pilocytic astrocytomas were enrolled in a prospective intergroup trial of radiotherapy (RT) after biopsy (3 patients) or observation after gross (11 patients) or subtotal (6 patients) resection. Results At the time of analysis (median follow-up, 20.8 years), 2 patients (10%) have died and 18 patients (90%) are alive. Neurologic and cognitive function were stable or improved over time for the majority of patients. No toxic effects of treatment or malignant transformations have been recorded at last follow-up. For the entire cohort the 20-year time to progression and overall survival rates are 95% and 90% respectively. The cause of death (2.2 and 16.1 years after enrollment) in both patients was unrelated to tumor although both were biopsy-only patients. One subtotally resected tumor progressed 1 month after enrollment requiring P32 injection into an enlarging cyst. Because of further progression this patient required RT 18 months later. This patient is alive without evidence of progression 18 years after RT. Conclusion The long-term follow-up results of this prospective trial confirm that adults with pilocytic astrocytomas have a favorable prognosis with regard to survival and neurologic function. Close observation is recommended for adults with pilocytic astrocytomas, reserving RT for salvage, as the majority remain stable after gross or subtotal resection and no adjuvant therapy.

Reappraisal of haemorrhagic suprasellar pilocytic astrocytoma during adulthood

2020 ◽  
Vol 13 (10) ◽  
pp. e235662
Author(s):  
Gustavo M Cortez ◽  
Andre Monteiro ◽  
Benjamin Ludwig ◽  
Ricardo Hanel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Surgical Treatment ◽  
Pilocytic Astrocytoma ◽  
Adult Population ◽  
Paediatric Population ◽  
Blood Products ◽  
Central Nervous System Tumour ◽  
Pilocytic Astrocytomas ◽  
Unfavourable Prognosis

Pilocytic astrocytomas comprise the most common central nervous system tumour during childhood and have an excellent response to surgical treatment in this population. The tumour incidence decreases with age, whereas more aggressive behaviour tends to increase. Haemorrhage as a presenting feature of pilocytic astrocytomas is a rare phenomenon, especially in the adult population. We present a case of a 55-year-old patient with progressive headaches and dizziness. MRI confirmed a sellar and predominantly retrochiasmal suprasellar lesion with heterogeneous signal, enhancement and blood products. Management via transsphenoidal approach was performed, and histopathology revealed the unexpected diagnosis of haemorrhagic pilocytic astrocytoma. Haemorrhagic pilocytic astrocytoma is an infrequent entity in the adult population and it is essential to recognise the peculiarities regarding diagnostic evaluation and management, which differ from the paediatric population. During adulthood, this tumour carries an overall unfavourable prognosis, with higher rates of progression and recurrence.

scholarly journals A Pilocytic Astrocytoma Mimicking a Clinoidal Meningioma

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher S. Hong ◽  
Norman L. Lehman ◽  
Eric Sauvageau
Keyword(s):  
Pilocytic Astrocytoma ◽  
Optic Tract ◽  
Rare Occurrence ◽  
Resonance Imaging ◽  
Dural Tail Sign ◽  
Pilocytic Astrocytomas ◽  
Intracranial Lesions ◽  
Dural Tail ◽  
Typical Appearance ◽  
Magnetic Resonance Imaging Mri

Pilocytic astrocytomas and meningiomas are benign, primary brain tumors that may involve the optic tract. Classically, the presence of a dural “tail” sign may differentiate a meningioma from other intracranial lesions. In this report, we describe a mass with the typical appearance of a clinoidal meningioma on magnetic resonance imaging (MRI) but postoperatively diagnosed as a pilocytic astrocytoma. This case illustrates the rare occurrence of a pilocytic astrocytoma mimicking a meningioma on MRI.

A population-based study of the incidence and survival rates in patients with pilocytic astrocytoma

2003 ◽  
Vol 98 (6) ◽  
pp. 1170-1174 ◽  
Author(s):  
Christoph Burkhard ◽  
Pier-Luigi Di Patre ◽  
Danielle Schüler ◽  
Georges Schüler ◽  
M. Gazi Yaşargil ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Postoperative Radiotherapy ◽  
Survival Rates ◽  
Population Based ◽  
Biological Behavior ◽  
Population Based Study ◽  
Content Type ◽  
Pilocytic Astrocytomas ◽  
The Mean ◽  
Fine Print

Object. The incidence of pilocytic astrocytomas and the rate of patient survival were analyzed in a population-based study in the canton of Zürich, Switzerland. Methods. Between 1980 and 1994, 987 astrocytic and oligodendroglial tumors were diagnosed, of which 55 (5.5%) were pilocytic astrocytomas. The incidence rate, adjusted to the World Standard Population, was 4.8 per 1 million per year. The mean age at clinical diagnosis was 19.6 ± 12.7 years, and the male/female ratio was 1.12. The most frequent tumor sites were the cerebellum (40%), followed by supratentorial locations (35%), the optic pathway and hypothalamus (11%), and the brainstem (9%). The mean follow-up period was 12 years. Observed survival rates were 100% at 5 years and 95.8% at 10 years after diagnosis (relative survival rate at 10 years: 96.8%). Seven patients (13%) received postoperative radiotherapy, but this did not significantly affect survival. In all patients the tumors were histologically classified as WHO Grade I, except in two patients who had anaplastic pilocytic astrocytoma (Grade III), one of whom died after 7 years, whereas the other was still alive after 10 years. Conclusions. This population-based study shows that, because of the benign biological behavior of pilocytic astrocytomas and advances in microneurosurgery, the survival rates for patients with these tumors are excellent, regardless of postoperative radiotherapy.

Immune cell infiltrate differences in pilocytic astrocytoma and glioblastoma: evidence of distinct immunological microenvironments that reflect tumor biology

2011 ◽  
Vol 115 (3) ◽  
pp. 505-511 ◽  
Author(s):  
Isaac Yang ◽  
Seunggu J. Han ◽  
Michael E. Sughrue ◽  
Tarik Tihan ◽  
Andrew T. Parsa
Keyword(s):  
Pilocytic Astrocytoma ◽  
Immune Cell ◽  
Tumor Biology ◽  
Human Leukocyte ◽  
Low Grade ◽  
High Grade ◽  
Cell Infiltrate ◽  
Leukocyte Antigen ◽  
Pilocytic Astrocytomas ◽  
Immune Cell Infiltrate

Object The tumor microenvironment in astrocytomas is composed of a variety of cell types, including infiltrative inflammatory cells that are dynamic in nature, potentially reflecting tumor biology. In this paper the authors demonstrate that characterization of the intratumoral inflammatory infiltrate can distinguish high-grade glioblastoma from low-grade pilocytic astrocytoma. Methods Tumor specimens from ninety-one patients with either glioblastoma or pilocytic astrocytoma were analyzed at the University of California, San Francisco. A systematic neuropathology analysis was performed. All tissue was collected at the time of the initial surgery prior to adjuvant treatment. Immune cell infiltrate not associated with necrosis or hemorrhage was analyzed on serial 4-μm sections. Analysis was performed for 10 consecutive hpfs and in 3 separate regions (total 30 × 0.237 mm2). Using immunohistochemistry for markers of infiltrating cytotoxic T cells (CD8), natural killer cells (CD56), and macrophages (CD68), the inflammatory infiltrates in these tumors were graded quantitatively and classified based on microanatomical location (perivascular vs intratumoral). Control markers included CD3, CD20, and human leukocyte antigen. Results Glioblastomas exhibited significantly higher perivascular (CD8) T-cell infiltration than pilocytic astrocytomas (62% vs 29%, p = 0.0005). Perivascular (49%) and intratumoral (89%; p = 0.004) CD56-positive cells were more commonly associated with glioblastoma. The CD68-positive cells also were more prevalent in the perivascular and intratumoral space in glioblastoma. In the intratumoral space, all glioblastomas exhibited CD68-positive cells compared with 86% of pilocytic astrocytomas (p = 0.0014). Perivascularly, CD68-positive infiltrate was also more prevalent in glioblastoma when compared with pilocytic astrocytoma (97% vs 86%, respectively; p = 0.0003). The CD3-positive, CD20-positive, and human leukocyte antigen-positive infiltrates did not differ between glioblastoma and pilocytic astrocytoma. Conclusions This analysis suggests a significantly distinct immune profile in the microenvironment of high-grade glioblastoma versus low-grade pilocytic astrocytoma. This difference in tumor microenvironment may reflect an important difference in the tumor biology of glioblastoma.

DNA methylation pattern of brain stem pilocytic astrocytomas in children

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10021-10021
Author(s):  
H. Witt ◽  
A. Korshunov ◽  
M. Remke ◽  
W. G. Janzarik ◽  
A. Gnekow ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Brain Stem ◽  
Pilocytic Astrocytoma ◽  
Disease Recurrence ◽  
Stem Cell Marker ◽  
Tumor Stem Cell ◽  
Who Grade ◽  
Genome Wide ◽  
Pilocytic Astrocytomas ◽  
Brain Stem Tumors

10021 Background: Pilocytic astrocytoma (WHO grade I) comprises the most frequent brain tumor in childhood. We were recently able to identify BRAF as a centrally important oncogene in these tumors showing duplication or activation in a majority of cases. Although histologically indistinguishable, tumors with brain stem location have a particularly poor prognosis. It is not well established, whether this is due to their close proximity to pivotal anatomic sites or due to distinct biological characteristics. Methods: To identify novel genes involved in astrocytoma pathogenesis, we performed a genome-wide DNA methylation analysis of 78 pilocytic astrocytoma samples from different tumor locations (diencephalic, cerebral, cerebellar, brain stem). BeadChip methylation technology was used to identify genes showing differential promoter methylation among tumors. Two CpG sites were analyzed for each of a total of 14.000 promoters per sample. Clinical and molecular subgroups were compared using Significance Analysis of Microarrays (SAM). Results: In this genome-wide approach, we identified an 11-gene signature that was able to correctly separate all brain stem tumors (n = 8) from the majority of tumors from other locations (56/70). Moreover, from 14 tumors clustering together with the brain stem tumors, 5 patients experienced disease recurrence (38%) as opposed to 20% in the remaining group. Genes contained in the signature most interestingly included three homeobox family genes (HOXB1, HOXD3, and HOXD4), and NES, a tumor stem cell marker. Conclusions: These data suggest that brain stem pilocytic astrocytomas display biologic features different from most tumors of other locations and share a methylation signature with tumors prone to disease recurrence from other locations. We provide first evidence for a role of differentially methylated homeobox family genes in the pathogenesis of pilocytic astrocytoma. No significant financial relationships to disclose.

Cystic Glioma of the Brain Stem with Prolonged Survival

Neurosurgery ◽  
1982 ◽  
Vol 10 (4) ◽  
pp. 499-502 ◽  
Author(s):  
Dov Soffer ◽  
Abraham Sahar
Keyword(s):  
Brain Stem ◽  
Pilocytic Astrocytoma ◽  
Unusual Case ◽  
Prolonged Survival ◽  
Biological Behavior ◽  
Favorable Prognosis ◽  
Pilocytic Astrocytomas ◽  
The Brain ◽  
Cystic Glioma

Abstract An unusual case of benign stem glioma with a 15-year survival is presented. In spite of 12 years of clinical quiescence, a focus of the tumor in the upper brain stem was found at necropsy. Morphologically, the tumor was a cystic pilocytic astrocytoma. The few previously reported similar cases in the same location were also associated with a favorable prognosis. It is suggested that, in analogy to the cystic cerebellar and cerebral astrocytomas, there is a group of cystic pilocytic astrocytomas of the brain stem with benign biological behavior.

scholarly journals mRNA and miRNA Expression Analyses of the MYC/E2F/miR-17-92 Network in the Most Common Pediatric Brain Tumors

2021 ◽  
Vol 22 (2) ◽  
pp. 543
Author(s):  
Renata Gruszka ◽  
Krzysztof Zakrzewski ◽  
Paweł Piotr Liberski ◽  
Magdalena Zakrzewska
Keyword(s):  
Gene Expression ◽  
Brain Tumors ◽  
Mirna Expression ◽  
Pilocytic Astrocytoma ◽  
Current Knowledge ◽  
Tumor Grade ◽  
Pediatric Brain Tumors ◽  
Who Grade ◽  
Pilocytic Astrocytomas ◽  
High Level

Numerous molecular factors disrupt the correctness of the cell cycle process leading to the development of cancer due to increased cell proliferation. Among known causative factors of such process is abnormal gene expression. Nowadays in the light of current knowledge such alterations are frequently considered in the context of mRNA–miRNA correlation. One of the molecular factors with potential value in tumorigenesis is the feedback loop between MYC and E2F genes in which miR-17-5p and miR-20a from the miR-17-92 cluster are involved. The current literature shows that overexpression of the members of the OncomiR-1 are involved in the development of many solid tumors. In the present work, we investigated the expression of components of the MYC/E2F/miR-17-92 network and their closely related elements including members of MYC and E2F families and miRNAs from two paralogs of miR-17-92: miR-106b-25 and miR-106a-363, in the most common brain tumors of childhood, pilocytic astrocytoma (PA), WHO grade 1; ependymoma (EP), WHO grade 2; and medulloblastoma (MB), WHO grade 4. We showed that the highest gene expression was observed in the MYC family for MYCN and in the E2F family for E2F2. Positive correlation was observed between the gene expression and tumor grade and type, with the highest expression being noted for medulloblastomas, followed by ependymomas, and the lowest for pilocytic astrocytomas. Most members of miR-17-92, miR-106a-363 and miR-106b-25 clusters were upregulated and the highest expression was noted for miR-18a and miR-18b. The rest of the miRNAs, including miR-19a, miR-92a, miR-106a, miR-93, or miR-25 also showed high values. miR-17-5p, miR-20a obtained a high level of expression in medulloblastomas and ependymomas, while close to the control in the pilocytic astrocytoma samples. miRNA expression also depended on tumor grade and histology.

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