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Multiple cystic brain lesions in a patient with pilocytic astrocytoma
S Senaratna1, A Hanieh, J Manson
1Department of Neurosurgery, Women's and Children's Hospital, North Adelaide, SA, Australia.
Insights
This case study highlights a rare pediatric pilocytic astrocytoma with widespread brain lesions. The unusual presentation involved multiple cystic cerebral lesions, a finding not previously reported in medical literature.
Area of Science:
- Neuro-oncology
- Pediatric Neurology
- Pathology
Background:
- Pilocytic astrocytomas are typically solitary tumors in the posterior cranial fossa.
- Disseminated pilocytic astrocytomas are rare, particularly in pediatric patients.
- Previous literature lacks reports of pilocytic astrocytoma presenting as multiple cystic brain lesions.
Observation:
- A 3-year-old boy presented with a 10-month history of headaches, vomiting, gait ataxia, and drowsiness.
- Magnetic resonance imaging (MRI) revealed extensive central nervous system lesions, including multiple cystic cerebral grey matter lesions.
- Pathological examination of a brain biopsy confirmed pilocytic astrocytoma.
Findings:
- This case represents an unusual presentation of pilocytic astrocytoma with widespread dissemination.
- The presence of multiple cystic cerebral lesions is a unique feature of this pediatric case.
- Neuraxis dissemination of pilocytic astrocytoma in children is exceedingly rare, with this case being unprecedented.
Implications:
- This case expands the understanding of pilocytic astrocytoma's potential clinical and radiological presentations.
- Highlights the importance of considering rare differential diagnoses in pediatric CNS tumors.
- Suggests the need for further research into the mechanisms of pilocytic astrocytoma dissemination.
Abstract:
Pilocytic astrocytomas are usually present as solitary posterior cranial fossa tumours. An unusual case of pilocytic astrocytoma in a 3 year and 8 month old boy is presented. The patient presented over the course of 10 months with intermittent headaches, vomiting, gait ataxia and drowsiness. After extensive investigations magnetic resonance imaging (MRI) revealed widespread lesions throughout the central nervous system, including multiple cystic cerebral grey matter lesions. A brain biopsy was performed and pathological studies revealed pilocytic astrocytoma. The literature pertaining to neuraxis dissemination of pilocytic astrocytomas in the paediatric population is reviewed. There are only a very limited number of reports of pilocytic astrocytoma ca using multiple brain lesions, with no publications of multiple cystic brain lesions. We believe this to be a unique case of pilocytic astrocytoma presenting with widespread cystic lesions throughout the brain.