Related Experiment Videos
May 1999--16 year old male with an unexpected MRI finding
S Patt1, N Haberland, H Graupner
1Institute of Pathology (Neuropathology), Friedrich-Schiller-Universität, Jena, Germany.
Abstract:
Four years after resection of a supratentorial pilocytic astrocytoma this 16-year-old boy displayed widespread leptomeningeal seeding. Although the primary tumor lacked contrast enhancement, the multiple metastatic nodules were markedly contrast enhancing. Both the initial and disseminated tumor were consistent with a pilocytic astrocytoma. He was treated with vincristin and carboplatinum and the tumor was stable up to Dec. 1998. Dissemination of low-grade intracranial astrocytoma in children occurs in only 4%. It is not a sign of malignancy. The present case is similar to previously published cases. The prognosis of these patients might be quite favorable when treated with radiotherapy and/or chemotherapy.
Insights
Widespread leptomeningeal seeding from pilocytic astrocytoma, though rare in children (4%), is not indicative of malignancy. This case highlights favorable prognosis with chemotherapy and radiotherapy.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Neurosurgery
Background:
- Pilocytic astrocytoma is the most common pediatric brain tumor.
- Leptomeningeal dissemination is a rare but recognized complication.
Observation:
- A 16-year-old boy presented with widespread leptomeningeal seeding four years after resection of a supratentorial pilocytic astrocytoma.
- The primary tumor showed no contrast enhancement, while metastatic nodules were highly contrast-enhancing.
- Tumor histology confirmed pilocytic astrocytoma in both primary and disseminated sites.
Findings:
- Leptomeningeal dissemination of pilocytic astrocytoma occurred in 4% of pediatric cases.
- Dissemination in this context does not signify malignancy.
- The patient's tumor remained stable with vincristine and carboplatinum treatment.
Implications:
- Prognosis for pediatric patients with pilocytic astrocytoma leptomeningeal dissemination can be favorable.
- Combined treatment modalities including chemotherapy and radiotherapy are recommended.
- Further research into optimal treatment strategies for disseminated pilocytic astrocytoma is warranted.