Complete surgical resection of high-grade astroblastoma with long time survival: case report and review of the literature

Abstract

SummaryAstroblastoma is a rare glial neoplasm of unknown origin and uncertain prognosis. It usually presents in young adults as a well circumscribed hemispheric mass, often associated with a cystic component. The histological features of astroblastoma are the presence of typical astroblastic perivascular pseudorosettes and perivascular hyalinization. Two different subtypes of astroblastoma have been defined based upon histological characteristics. Prognosis, however, sometimes is in contradiction with the pathological appearance and seems to be more closely related to the grade of surgical resection. We present a new case of a patient with a high-grade astroblastoma with a long survival time, in whom complete surgical resection was confirmed by an early postoperative MRI.KEY WORDS: Astroblastoma. Glial tumor. Treatment. Prognosis.Astroblastoma de alto grado con supervivencia prolongada tras resección completa: descripción de un caso y revisión de la literatura Resumen El astroblastoma es un tumor glial infrecuente de origen desconocido y pronóstico incierto. Habitualmente se presenta en adultos como una masa hemisférica bien definida, presentando a menudo un componente quístico. Las características histopatológicas de este tumor incluyen la presencia de pseudorrosetas perivasculares astroblásticas típicas y la hialinización perivascular. Se han distinguido dos tipos de astroblastoma en relación a la malignidad histológica. Sin embargo, el pronóstico en ocasiones no guarda relación directa con el tipo histológico y parece más dependiente del grado de resección quirúrgica. Presentamos el caso de una paciente con un astroblastoma de alto grado con supervivencia prolongada, en el cual la resección quirúrgica completa se demostró mediante resonancia magnética postoperatoria precoz.

Anaplastic astroblastoma: a rare glial tumour

“…In one study, it was proved that cells of astroblastoma are intermediate between astrocytes and ependymal cells 15 16. Clinical signs and symptoms were dependent on the localisation and size of the neoplasm, with headache and seizure being the most frequent 17. The presented case had severe headache and diplopia and did not have the history of seizure.…”

Astroblastoma in a Young Female Patient: A Case Report and Literature Review of Clinicopathological, Radiological and Prognostic Characteristics and Current Treatment Strategies

“…Typically, astroblastoma develop in the cerebral hemispheres, most likely affecting the frontal lobe followed by parietal and temporal lobes [ 2 ]. Nevertheless, such tumors has also been reported at other locations of the central nervous system, like the corpus callosum, cerebellum, brainstem, intraventricular or cauda equine [ 5 18 19 ].…”

“…The most common clinical symptoms of astroblastoma include headache [ 6 ], as also observed in this study. History of seizures, nausea, vomiting, progressive hemiparesis and coma has also been reported [ 4 5 6 ]. Occasionally, symptoms such as diplopia, dizziness and confusion have also been documented [ 20 ].…”

“…In general, astroblastomas are large, peripheral and solid (with occasional cystic component) brain tumors. Typical clinical manifestation of these tumors includes headache, seizures, nausea, vomiting, and decay in conscious level [ 4 5 6 ]. The characteristic radiological appearance of astroblastoma more likely illustrate heterogeneous hyperintense signal on T2-wieghted sequences (T2WS), and fluid-attenuated inversion recovery (FLAIR) images, hypointense to isointense on T1-weighted sequences (T1WS), with characteristic “bubbly” appearance.…”

“…The cystic component demonstrate rim enhancement. Tumor associated vasogenic edema may also be present [ 5 7 8 9 10 ]. The histopathological features of astroblastoma include perivascular arrangement of neoplastic cells having thick, stout and short cytoplasmic processes with peripheral nuclei, forming pseudorosettes giving the characteristic “cartwheel” appearance [ 4 5 6 11 12 13 14 ].…”