Low-grade astroblastoma recurring with extensive invasion.

Area of Science:

• Neuro-oncology
• Pediatric Neurosurgery

Background:

• Astroblastoma is a rare glial tumor, often presenting in young adults.
• This case highlights the diagnostic and therapeutic challenges associated with low-grade astroblastoma.

Observation:

• A 17-year-old male presented with headache and double vision.
• Neuroimaging revealed a lobulated mass with peritumoral edema and high methionine uptake.
• Initial resection showed well-differentiated tumor cells with perivascular pseudorosettes, diagnosed as low-grade astroblastoma.

Findings:

• Recurrence occurred 5 months post-surgery, with tumor invasion into subpial and perivascular spaces.
• A second surgery followed by adjuvant radiotherapy and combination chemotherapy was administered.
• Complete remission was achieved after six courses of ifosfamide, cisplatin, and etoposide chemotherapy.

Implications:

• While gross total resection often leads to good outcomes, aggressive recurrence is possible.
• This case underscores the need for multimodal treatment strategies for recurrent astroblastoma.
• Further research into the biology and optimal management of astroblastoma is warranted.