Journal of Korean Neurosurgical Society

  • 제60권3호
  • /
  • Pages.375-379
  • /
  • 2017
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Endoscopic Treatment of an Adult with Tegmental Astrocytoma Accompanied by Cerebrospinal Fluid Dissemination

  • 투고 : 2013.08.22
  • 심사 : 2014.10.12
  • 발행 : 2017.05.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Midbrain gliomas are relatively rare neoplasms with a generally benign prognosis, with dissemination or metastasis not previously reported. We describe here a woman, in whom magnetic resonance imaging scans showed hydrocephalus and a tegmental lesion in the upper aqueduct. Endoscopic third ventriculostomy and biopsy were performed; during surgery, a second small lesion was observed in the infundibular recess. Histologically, the two lesions had the characteristics of low grade astrocytoma, suggesting that the midbrain astrocytoma may have been disseminated via the cerebral spinal fluid to the infundibular recess. Postoperatively this patient received radiotherapy for nearly one month. Although patients with these tumors are not usually administered adjunctive therapy, radiation and, combined modality therapy, including surgery, radiotherapy, and chemotherapy, may be beneficial in patients with midbrain gliomas with dissemination.

키워드

참고문헌

  1. Andrychowski J, Taraszewska A, Czernicki Z, Jurkiewicz J, Netczuk T, Dabrowski P : Ten years observation and treatment of multifocal pilocytic astrocytoma. Folia Neuropathol 47 : 362-370, 2009
  2. Buschmann U, Gers B, Hildebrandt G : Pilocytic astrocytomas with leptomeningeal dissemination : biological behavior, clinical course, and therapeutical options. Childs Nerv Syst 19 : 298-304, 2003 https://doi.org/10.1007/s00381-003-0746-9
  3. Dominguez-Paez M, Puch-Ramirez M, Rodriguez-Barcelo S, Medina-Imbroda JM, Romero-Moreno L, Ibanez-Botella G, et al. : Neuroendoscopic biopsy. Experience in 31 patients and literature review. Neurocirugia (Astur) 22 : 419-427; discussion 428, 2011
  4. Faria AV, Azevedo GC, Zanardi VA, Ghizoni E, Queiroz LS : Dissemination patterns of pilocytic astrocytoma. Clin Neurol Neurosurg 108 : 568-572, 2006 https://doi.org/10.1016/j.clineuro.2005.01.006
  5. Figueiredo EG, Matushita H, Machado AG, Plese JP, Rosemberg S, Marino R Jr : Leptomeningeal dissemination of pilocytic astrocytoma at diagnosis in childhood : two cases report. Arq Neuropsiquiatr 61(3B) : 842-847, 2003 https://doi.org/10.1590/S0004-282X2003000500025
  6. Gajjar A, Bhargava R, Jenkins JJ, Heideman R, Sanford RA, Langston JW, et al. : Low-grade astrocytoma with neuraxis dissemination at diagnosis. J Neurosurg 83 : 67-71, 1995 https://doi.org/10.3171/jns.1995.83.1.0067
  7. Hamilton MG, Lauryssen C, Hagen N : Focal midbrain glioma : long term survival in a cohort of 16 patients and the implications for management. Can J Neurol Sci 23 : 204-207, 1996 https://doi.org/10.1017/S031716710003852X
  8. Jamjoom AB, Jamjoom ZA, al-Rayess M : Intraventricular and leptomeningeal dissemination of a pilocytic cerebellar astrocytoma in a child with a ventriculoperitoneal shunt : case report. Br J Neurosurg 12 : 56-58, 1998 https://doi.org/10.1080/02688699845555
  9. Lazaro BC, Landeiro JA : Tectal plate tumors. Arq Neuropsiquiatr 64 (2B) : 432-436, 2006 https://doi.org/10.1590/S0004-282X2006000300015
  10. Li KW, Roonprapunt C, Lawson HC, Abbott IR, Wisoff J, Epstein F, et al. : Endoscopic third ventriculostomy for hydrocephalus associated with tectal gliomas. Neurosurg Focus 18(6A) : E2, 2005 https://doi.org/10.3171/foc.2005.18.3.15
  11. Moon JH, Jung TY, Jung S, Jang WY : Leptomeningeal dissemination of a low-grade brainstem glioma without local recurrence. J Korean Neurosurg Soc 51 : 109-112, 2012 https://doi.org/10.3340/jkns.2012.51.2.109
  12. Oka K, Kin Y, Go Y, Ueno Y, Hirakawa K, Tomonaga M, et al. : Neuroendoscopic approach to tectal tumors : a consecutive series. J Neurosurg 91 : 964-970, 1999 https://doi.org/10.3171/jns.1999.91.6.0964
  13. Oppido PA, Fiorindi A, Benvenuti L, Cattani F, Cipri S, Gangemi M, et al. : Neuroendoscopic biopsy of ventricular tumors : a multicentric experience. Neurosurg Focus 30 : E2, 2011
  14. Pollack IF, Hurtt M, Pang D, Albright AL : Dissemination of low grade intracranial astrocytomas in children. Cancer 73 : 2869-2878, 1994 https://doi.org/10.1002/1097-0142(19940601)73:11<2869::AID-CNCR2820731134>3.0.CO;2-I
  15. Redhu R, Nadkarni TD : Multicompartmental cerebrospinal fluid dissemination of cerebellar pilocytic astrocytoma at presentation. J Clin Neurosci 18 : 1412-1414, 2011 https://doi.org/10.1016/j.jocn.2011.01.038
  16. Sakai K, Miyahara T, Tsutsumi K, Kaneko T, Fukushima M, Tanaka Y, et al. : Spontaneous regression of multicentric pilocytic astrocytoma with CSF dissemination in an adult. Brain Tumor Pathol 28 : 151-156, 2011 https://doi.org/10.1007/s10014-010-0015-z
  17. Salvati M, Oppido PA, Artizzu S, Fiorenza F, Puzzilli F, Orlando ER : Multicentric gliomas. Report of seven cases. Tumori 77 : 518-522, 1991 https://doi.org/10.1177/030089169107700614
  18. Selvapandian S, Rajshekhar V, Chandy MJ : Brainstem glioma : comparative study of clinico-radiological presentation, pathology and outcome in children and adults. Acta Neurochir (Wien) 141 : 721-726; discussion 726-727, 1999 https://doi.org/10.1007/s007010050367
  19. Tirakotai W, Hellwig D, Bertalanffy H, Riegel T : The role of neuroendoscopy in the management of solid or solid-cystic intra- and periventricular tumours. Childs Nerv Syst 23 : 653-658, 2007 https://doi.org/10.1007/s00381-007-0328-3
  20. Uro-Coste E, Ssi-Yan-Kai G, Guilbeau-Frugier C, Boetto S, Bertozzi AI, Sevely A, et al. : Desmoplastic infantile astrocytoma with benign histological phenotype and multiple intracranial localizations at presentation. J Neurooncol 98 : 143-149, 2010 https://doi.org/10.1007/s11060-009-0075-2
  21. Wang C, Zhang J, Liu A, Sun B, Zhao Y : Surgical treatment of primary midbrain gliomas. Surg Neurol 53 : 41-51, 2000 https://doi.org/10.1016/S0090-3019(99)00165-2
  22. Wellons JC 3rd, Tubbs RS, Banks JT, Grabb B, Blount JP, Oakes WJ, et al. : Long-term control of hydrocephalus via endoscopic third ventriculostomy in children with tectal plate gliomas. Neurosurgery 51 : 63-67; discussion 67-68, 2002 https://doi.org/10.1097/00006123-200207000-00010
  23. Yeh DD, Warnick RE, Ernst RJ : Management strategy for adult patients with dorsal midbrain gliomas. Neurosurgery 50 : 735-738; discussion 738-740, 2002 https://doi.org/10.1097/00006123-200204000-00009