Brain-stem glioma growth patterns

Abstract

During the last decade, several authors have reported that certain brain-stem gliomas may be associated with a better prognosis than others. In this paper, retrospective correlations between the pathological findings and the magnetic resonance (MR) imaging appearance of 88 brain-stem gliomas are established. The authors propose an anatomical hypothesis that helps identify glioma growth patterns in general and that clarifies why cervicomedullary, dorsally exophytic, and focal tumors have a more favorable prognosis. According to this hypothesis, growth of benign gliomas of the brain stem is guided by secondary structures such as the pia, fiber tracts, and the ependyma, which in turn leads to stereotypical growth patterns that are clearly identified on MR images. The authors believe that this hypothesis, in conjunction with clinical data, may help establish selection criteria for the surgical treatment of specific brain-stem lesions.

Diffuse brainstem glioma: prognostic factors

“…Most authors regard biopsy procedures for intrinsic brainstem tumors as being too dangerous and consider imaging methods as sufficiently reliable. 1,5 Thus, the impact of MRI findings on treatment decisions for brainstem tumors is very high, but the accuracy of MRI-based diagnosis of diffuse brainstem gliomas has not been fully verified by histopathological findings. 8 Thus, some authors have reported that all diffuse brainstem gliomas located above the medulla behave as high-grade astrocytomas, and histological grade is not a significant factor for the survival of these patients.…”

“…8 Thus, some authors have reported that all diffuse brainstem gliomas located above the medulla behave as high-grade astrocytomas, and histological grade is not a significant factor for the survival of these patients. 1,4,5,18,20 Few studies have been conducted concerning prognosis and prognostic factors in brainstem gliomas. 1 This may be due to the low incidence of these tumors and the fact that histopathological diagnosis is rarely confirmed.…”

Isolated Oculomotor Nerve Paresis in Anaplastic Astrocytoma With Exophytic Invasion

“…Malignant astrocytomas usually invade along the myelinated fiber tracts of the white matter and exophytic extension is extremely rare, although astrocytomas in the brainstem and cerebellum occasionally grow exophytically into the fourth ventri-Isolated Oculomotor Nerve Paresis in Anaplastic Astrocytoma cle and the cerebellopontine angle cistern. 3,19) In contrast, the growth patterns of gliomas depend on both the biological behavior, and the location and correlation to the surrounding normal structures. In our case, the temporal horn of the left lateral ventricle was displaced posterolaterally by the tumor, so we suspect that the rapid growth of the tumor contributed to the macroscopic expansion, resulting in the tumor extending medially to the cisterns.…”

Ganglioglioma de tallo cerebral en mujer adolescente

“…1 La evaluación de este tumor se realizó de acuerdo con las clasificaciones radiológicas de Epstein y de Choux. 2 En dichas clasificaciones no se toma en cuenta la posible estirpe tumoral como la topografía de la lesión y han provocado un cambio en la conducta que antiguamente se seguía con las neoplasias del tallo; esto es: exisFigura 1. Resonancia magnética cerebral.…”