pilocytic astrocytoma
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Author(s):  
Shekhar Kumar Keshri ◽  
Satyendra Narayan Sinha

Pilocytic astrocytoma (PA) is a low grade benign tumor, commonly occurs in Cerebellum (42-60%), Optic & hypothalamic region (9-30%), Brain Stem (9%). They rarely spread. It rarely occurs within the ventricle. In this report, we described our experience with cranial pilocytic astrocytoma in a 14-year-old child, who initially treated with near total decompression of tumor. Four and half years later, recurrence of primary tumor with obstructive hydrocephalus occurred for which he underwent ventriculo-peritoneal shunt followed by re-excision. As further treatment was being evaluated for radiotherapy in view of recurrence at the primary site, he got detected to have significant spinal drop metastasis seen on MRI Spine. Finally, he underwent craniospinal irradiation (CSI).


2022 ◽  
Vol 10 (19) ◽  
pp. 41-47
Author(s):  
Ana L. Pichardo-Ávalos

Pilocytic astrocytoma of the cerebellum in the pediatric age is the most frequent benign tumor lesion of the nervous system in children according to the WHO. International literature mentions that being low-grade tumors they have a high curative capacity. If the entire tumor is resected, when it is completely removed, survival increases with a high quality of life for children who presented this pathology and was treated on time. However, the delay in diagnosis and therefore in its treatment could generate the possibility of tumor transformation, the malignant nature of the transformed injuries has a very high morbidity and mortality, without mentioning that the degree of cognitive sequelae greatly affects the quality of life of the survivors. That is why the training of pediatric and non-pediatric first contact doctors imply a great responsibility since it gives the population and patients suffering from this nosology the possibility to improve their future life, as well as reduce the cost of the impact caused by the injuries they suffer. On the other hand, these tumors can transform generating devastating prognoses, without taking into account the economic and social repercussions of patients suffering from a low-grade tumor. When it is detected and treated assertively in a timely manner, it offers them greater opportunities than those who did not have such a timely diagnosis.


Author(s):  
Nicole M Brossier ◽  
Jennifer M Strahle ◽  
Samuel J Cler ◽  
Michael Wallendorf ◽  
David H Gutmann

Summary Tumor location has been proposed as a prognostic factor for pilocytic astrocytoma (PA), but since resection status varies by CNS location, these two variables are difficult to separate on multivariate analysis. To eliminate resection status as a confounding variable, we analyzed the outcomes of children with subtotally resected PA by brain location. We found that individuals with PA in the supratentorial midline region had an increased likelihood of multiple progression events. These children also exhibited more neurologic deficits over time compared to those with brainstem PA, frequently due to worsening vision and the acquisition of new endocrinopathies or weakness.


Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 26
Author(s):  
Lisa Novello ◽  
Nivedita Agarwal ◽  
Sabina Vennarini ◽  
Stefano Lorentini ◽  
Domenico Zacà ◽  
...  

Proton beam therapy (PBT) is an effective pediatric brain tumor treatment. However, the resulting microstructural changes within and around irradiated tumors are unknown. We retrospectively applied diffusion tensor imaging (DTI) and free-water imaging (FWI) on diffusion-weighted magnetic resonance imaging (dMRI) data to monitor microstructural changes during the PBT and after 8 months in a pilocytic astrocytoma (PA) and normal-appearing white matter (NAWM). We evaluated the conventional MRI- and dMRI-derived indices from six MRI sessions (t0–t5) in a Caucasian child with a hypothalamic PA: at baseline (t0), during the PBT (t1–t4) and after 8 months (t5). The tumor voxels were classified as “solid” or “fluid” based on the FWI. While the tumor volume remained stable during the PBT, the dMRI analyses identified two different response patterns: (i) an increase in fluid content and diffusivity with anisotropy reductions in the solid voxels at t1, followed by (ii) smaller variations in fluid content but higher anisotropy in the solid voxels at t2–t4. At follow-up (t5), the tumor volume, fluid content, and diffusivity in the solid voxels increased. The NAWM showed dose-dependent microstructural changes. The use of the dMRI and FWI showed complex dynamic microstructural changes in the irradiated mass during the PBT and at follow-up, opening new avenues in our understanding of radiation-induced pathophysiologic mechanisms in tumors and the surrounding tissues.


2021 ◽  
Author(s):  
Konstantin Okonechnikov ◽  
Piyush Joshi ◽  
Mari Sepp ◽  
Kevin Leiss ◽  
Ioannis Sarropoulos ◽  
...  

Understanding the cellular origins of childhood brain tumors is key for discovering novel tumor-specific therapeutic targets. Previous strategies mapping cellular origins typically involved comparing human tumors to murine embryonal tissues, a potentially imperfect approach due to spatio-temporal gene expression differences between species. Here we use an unprecedented single-nucleus atlas of the developing human cerebellum (Sepp, Leiss, et al) and extensive bulk and single-cell transcriptome tumor data to map their cellular origins with focus on three most common pediatric brain tumors - pilocytic astrocytoma, ependymoma, and medulloblastoma. Using custom bioinformatics approaches, we postulate the astroglial and glial lineages as the origins for posterior fossa ependymomas and radiation-induced gliomas (secondary tumors after medulloblastoma treatment), respectively. Moreover, we confirm that SHH, Group3 and Group4 medulloblastomas stem from granule cell/unipolar brush cell lineages, whereas we propose pilocytic astrocytoma to originate from the oligodendrocyte lineage. We also identify genes shared between the cerebellar lineage of origin and corresponding tumors, and genes that are tumor specific; both gene sets represent promising therapeutic targets. As a common feature among most cerebellar tumors, we observed compositional heterogeneity in terms of similarity to normal cells, suggesting that tumors arise from or differentiate into multiple points along the cerebellar "lineage of origin".


2021 ◽  
Vol 8 (3) ◽  
pp. 395-411
Author(s):  
Dewa Kartika ◽  
Baskoro Nurdopo

Pendahuluan Butterfly Glioma adalah high grade astrocytoma, biasanya glioblastoma (WHO grade IV), yang melintasi garis tengah melalui corpus callosum. Komissura white matter lainnya kadang juga terlibat. Istilah kupu-kupu mengacu pada ekstensi yang melewati garis tengah seperti sayap. Butterfly Glioma paling sering terjadi di lobus frontal, melintasi garis tengah melalui genu corpus callosum, namun butterfly glioma posterior kadang juga ditemui. Laporan kasus Seorang pasien laki-laki usia 24 tahun dengan keluhan utama 9 bulan, yang lalu. Penglihatan kabur, konsentrasi menurun. Kejang(-). Kemudian 3 bulan yang lalu mata tidak bisa melihat. Dan 1 bulan yang lalu tubuh lemas susah digerakkan Pemeriksaan patologi anatomi menunjukkan Pylocytic Astrocytoma. Pemeriksaan CT scan kepala menunjukkan  Massa solid inhomogen intraxial ( ukuran ± AP 7,6 x 8,9 x CC 6,2 cm ) disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema à curiga gambaran glioblastoma multiformis.   Pembahasan Hasil pemeriksaan anamnesis dan pemeriksaan fisik pasien ini menunjukkan kecurigaan adanya SOL. Pemeriksaan CT scan kepala menunjukkan  Massa solid inhomogen intraxial disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema à curiga gambaran glioblastoma multiformis. Dari PA didapatkan hasil Pilocytic astrocytoma. Sedangkan gambaran radiologi Pilocytic astrocytoma berupa lesi kistik dengan nodul mural yang enhanced. Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan.. Modalitas imejing pilihan yang dapat dilakukan pada kasus Butterfly Glioblastoma adalah CT scan dan MRI. Kesimpulan Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan. Dan pemeriksaan radiologis yang dapat digunakan pada Butterfly Glioblastoma adalah CT scan dan MRI.


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