Diagnosis and management challenge of a granular cell astrocytoma of the pineal region: case report

Abstract

<jats:p>Granular cell astrocytoma (GCA) is a rare type of infiltrative brain tumor with most reported cases occurring in the suprasellar region. A pineal localization is extremely rare, with only 4 previously reported cases in the literature. The authors describe the case of a 16-year-old boy who developed signs of increased intracranial pressure and Parinaud syndrome. Cranial CT and MRI revealed a well-demarcated and enhanced mass in the pineal region accompanied by obstructive hydrocephalus. Subtotal resection was performed via a subtemporal approach. A histological diagnosis of GCA was made. Three years after surgery, the patient was alive and well without adjuvant therapy, and serial MRI showed no signs of progression of a small residual tumor. After a thorough review of the different epidemiological, clinical, and imaging features; treatments; and prognoses of GCAs in other intracranial localizations, the authors analyzed features of this tumor in the pineal region.</jats:p>

Granular cell tumors in the central nervous system: a report on eight cases and a literature review

“…17 Less than 70 cases of GCA have been reported in the literature. 18 The GCT at the cerebral hemisphere in our report was separated from the dura matter by thin brain parenchyma. The tumor was presumed to originate from the parenchyma; and although GCA was highly suspected, no astrocytomatous components were observed (patient 6).…”

“…22 Although GCA can be entirely composed of granular cells, they often consist of a combination of granular cells and conventional infiltrating astrocytoma. 18 Granular cells vary in quantity, usually ranging from 30 to 100% of the tumor cells. 17 The histogenesis of GCA is still unclear, and the positive GFAP immunostaining and its coexistence with conventional astrocytoma suggest an astrocytic origin.…”

Granular cell tumor of the brain: case report and review of literature

“…Generally, all GCAs occur in the cerebral hemispheres and are a type of infiltrative brain tumor, with most reported cases occurring in the suprasellar region. GCAs can be seen, although very rarely infratentorial within the cerebellum or spinal cord [ 11 ].…”