Cerebellar pilocytic astrocytomas with spontaneous intratumoral hemorrhage in the elderly

Sun, Shuo; Zhou, Hui; Ding, Zhao-Zheng; Shi, Hui

doi:10.1097/md.0000000000011329

Cited by 7 publications

(9 citation statements)

References 19 publications

(17 reference statements)

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“…Previous reports have stated that the absence of pathological findings indicative of spontaneous hemorrhage is not uncommon. 6,13,19,24 As regards angiographic findings, Suzuki et al have reported the case of a diencephalic PA presenting with no vascular abnormality on DSA. 25 Although 1 case in this study presented with vascular abnormality on DSA, such cases would be relatively rare among hemorrhagic cases.…”

Section: Spontaneous Hemorrhage In Lggsmentioning

confidence: 99%

Association of the FGFR1 mutation with spontaneous hemorrhage in low-grade gliomas in pediatric and young adult patients

Ishi

Yamaguchi

Hatanaka

et al. 2021

Journal of Neurosurgery

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OBJECTIVEThe authors aimed to investigate genetic alterations in low-grade gliomas (LGGs) in pediatric and young adult patients presenting with spontaneous hemorrhage.METHODSPatients younger than 30 years of age with a pathological diagnosis of World Health Organization (WHO) grade I or II glioma and who had undergone treatment at the authors’ institution were retrospectively examined. BRAF V600E, FGFR1 N546/K656, IDH1 R132, IDH2 R172, and KIAA1549-BRAF (K-B) fusion genetic alterations were identified, and the presence of spontaneous tumoral hemorrhage was recorded.RESULTSAmong 66 patients (39 with WHO grade I and 27 with grade II tumors), genetic analysis revealed K-B fusion in 18 (27.3%), BRAF V600E mutation in 14 (21.2%), IDH1/2 mutation in 8 (12.1%), and FGFR1 mutation in 4 (6.1%). Spontaneous hemorrhage was observed in 5 patients (7.6%); 4 of them had an FGFR1 mutation and 1 had K-B fusion. Univariate analysis revealed a statistically significant association of an FGFR1 mutation and a diencephalic location with spontaneous hemorrhage. Among 19 diencephalic cases including the optic pathway, hypothalamus, and thalamus, an FGFR1 mutation was significantly associated with spontaneous hemorrhage (p < 0.001). Four FGFR1 mutation cases illustrated the following results: 1) a 2-year-old female with pilomyxoid astrocytoma (PMA) harboring the FGFR1 K656E mutation presented with intraventricular hemorrhage (IVH); 2) a 6-year-old male with PMA harboring FGFR1 K656E and D652G mutations presented with intratumoral hemorrhage (ITH); 3) a 4-year-old female with diffuse astrocytoma harboring FGFR1 K656M and D652G mutations presented with IVH; and 4) a young adult patient with pilocytic astrocytoma with the FGFR1 N546K mutation presented with delayed ITH and IVH after 7 years of observation.CONCLUSIONSAlthough the mechanism remains unclear, the FGFR1 mutation is associated with spontaneous hemorrhage in pediatric and young adult LGG.

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Section: Spontaneous Hemorrhage In Lggsmentioning

confidence: 99%

Association of the FGFR1 mutation with spontaneous hemorrhage in low-grade gliomas in pediatric and young adult patients

Ishi

Yamaguchi

Hatanaka

et al. 2021

Journal of Neurosurgery

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“…[ 18 , 24 ] Sixteen cases of cerebellar hemorrhage from PA with various clinical presentations have been previously reported. [ 2 - 5 , 7 , 9 , 10 , 13 - 15 , 18 - 20 , 22 , 23 , 25 ] [ Table 1 ]. The etiology of intratumoral hemorrhage in PA is unclear, but in the present case, the tumor tissue had abundant microvasculature with a glomeruloid-like appearance [ Figure 2 ].…”

Section: Discussionmentioning

confidence: 99%

Critical cerebellar hemorrhage due to pilocytic astrocytoma in a child: A case report

Teshigawara¹,

Kimura²,

Ichi³

2021

Surgical Neurology International

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Background: Cerebellar hemorrhage is rare in children, and its cause is usually vascular disorders such as arteriovenous malformations or hematological disorders. Case Description: A previously healthy 10-year-old girl presented with a loss of consciousness following sudden headache and vomiting. A non-contrast brain computed tomography (CT) scan revealed a massive cerebellar hemorrhage with obstructive hydrocephalus; however, subsequent CT angiography (CTA) showed no vascular abnormalities. An emergency craniotomy was performed to evacuate the hematoma, and histological analysis of the specimen obtained from the tissue surrounding the hematoma revealed a pilocytic astrocytoma (PA). Six months after the ictus, her recovery was scored at 2 on the modified Rankin Scale. Conclusion: PA can be a cause of critical cerebellar hemorrhage. In this case of life-threatening massive hematoma, CTA was useful to exclude a major vascular pathology and to save time.

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“…Pilocytic astrocytoma is the most common primary brain tumor in pediatric population, comprising about 30% of all pediatric central nervous system tumors, 85% of all posterior fossa astrocytomas, and 10% of all cerebral astrocytomas in children. [1,2,4,7,8] The cerebellum, the brainstem, the optic nerve and chiasm, and the thalamus/ basal ganglia region are the most common locations of the lesion, with predilection within or near the midline sections. [2,5,8,9] Signs and symptoms commonly found in cerebellar pilocytic astrocytoma include headache, neck pain, vomiting, ataxia, and diplopia.…”

Section: Discussionmentioning

confidence: 99%

“…[1] This tumor is a slow-growing neuroglioma, found among children and adolescents, usually located at the posterior cranial fossa, and has a classic imaging manifestation of a solitary, cyst-like mass with a strong contrast-enhancing mural nodule. [2][3][4][5] Multiple pilocytic astrocytomas in a single patient is a less common manifestation. [3,6] According to our knowledge, there has only been three publications on multiple involvement of pilocytic astrocytoma and 11 published articles on spontaneous intracystic hemorrhage in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Multiple lesions accompanied by postoperative spontaneous intracystic hemorrhage in a pediatric patient with pilocytic astrocytoma

Parenrengi

Aji

2020

Asian J Neurosurg

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Pilocytic astrocytoma is the most common primary brain tumor in the pediatric population and has a classic imaging manifestation of a solitary, cyst-like mass with a strong contrast-enhancing mural nodule. Here, we report a case of multiple lesions in pilocytic astrocytoma in a pediatric patient accompanied by postoperative spontaneous intracystic hemorrhage. We describe the case of a 14-year-old female patient with a history of surgery for right cerebellar tumor 6 years ago. Computed tomography (CT) and magnetic resonance imaging showed cystic lesion with a mural nodule in the cerebellum and right retrothalamic area, suggesting a pilocytic astrocytoma. Emergency surgery was done. Pathology confirmed a pilocytic astrocytoma World Health Organization Grade 1. During postoperative course, clinical outcomes of the patient did not improve. Follow-up CT showed cystic remnant compressing the brain stem with spontaneous intracystic hemorrhage. The second surgery was done to evacuate the hemorrhage and to remove the cyst. Serial CT was made after the second surgery with no cyst growth nor hemorrhage present. Only three other pediatric multiple pilocytic astrocytomas have been reported previously, and there were only 11 publications about spontaneous intracystic hemorrhage in pediatric pilocytic astrocytoma. Our review of all previously reported cases found that the patients were predominantly male, and some had a history of neurofibromatosis type 1.

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Cerebellar pilocytic astrocytomas with spontaneous intratumoral hemorrhage in the elderly

Cited by 7 publications

References 19 publications

Association of the FGFR1 mutation with spontaneous hemorrhage in low-grade gliomas in pediatric and young adult patients

Association of the FGFR1 mutation with spontaneous hemorrhage in low-grade gliomas in pediatric and young adult patients

Critical cerebellar hemorrhage due to pilocytic astrocytoma in a child: A case report

Multiple lesions accompanied by postoperative spontaneous intracystic hemorrhage in a pediatric patient with pilocytic astrocytoma

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