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Extensive surgical excision of large hemispheric "malignant" astrocytoma in a 6-week-old infant
N E Epstein1, S L Sundrani, A D Rosenthal
1Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11040.
Insights
Aggressive surgical excision of high-grade astrocytomas in infants can lead to positive outcomes. This case report shows a child surviving and thriving 1.5 years post-operation without radiation or chemotherapy.
Area of Science:
- Pediatric Neurosurgery
- Oncology
- Developmental Neuroscience
Background:
- High-grade astrocytomas are rare but aggressive brain tumors in infants.
- Neonatal brain tumors present unique diagnostic and therapeutic challenges.
- Early diagnosis and intervention are critical for improving outcomes in pediatric oncology.
Observation:
- A 6-week-old infant was diagnosed with a massive hemispheric high-grade astrocytoma.
- The tumor was completely removed through two craniotomies.
- The infant exhibited minimal neurological deficits post-surgery.
Findings:
- Complete surgical excision of massive malignant neonatal astrocytomas is feasible.
- Aggressive surgical management, without adjuvant therapies like radiation or chemotherapy, can be effective.
- The child remained alive and well 1.5 years after the surgical procedure.
Implications:
- This case highlights the potential for long-term palliation through extensive surgical resection of neonatal brain tumors.
- The plasticity of the developing nervous system may contribute to minimizing surgical deficits.
- Aggressive surgical excision should be considered a primary treatment option for massive malignant neonatal astrocytomas.
Abstract:
A massive hemispheric "high"-grade astrocytoma, diagnosed in a 6-week-old infant, was totally excised by means of two craniotomies. The child is still alive and well with minimal neurological dysfunction 1.5 years after operation. This case report illustrates the benefit of aggressive surgical excision (without radiation or chemotherapy) of massive malignant neonatal astrocytomas. While surgical deficits may be minimized by the plasticity of the developing nervous system, extensive excision may yield occasional long-term palliation.