Neuroimaging features of angiocentric glioma: A case series and systematic review

Abstract

Background and Purpose: Angiocentric gliomas (AGs) are epileptogenic low-grade gliomas in young patients. We aimed to investigate the MRI findings of AGs and systematically review previous publications and three new cases. Methods:We searched PubMed, Elsevier's abstract and citation database, and Embase databases and included 50 patients with pathologically proven AGs with analyzable preoperative MRI including 3 patients from our institution and 47 patients from 38 publications (median age, 13 years [range, 2-83 years]; 35 men). Two board-certified radiologists reviewed all images. The relationships between seizure/epilepsy history and MRI findings were statistically analyzed. Moreover, clinical and imaging differences were evaluated between supratentorial and brainstem AGs.Results: Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain parenchymal atrophy were observed in 23 out of 50 (46.0%), 10 out of 50 (20.0%), and 14 out of 50 (28.0%) patients, respectively. Intratumoral T1-weighted high-intensity areas were observed significantly more frequently in patients with stalk-like signs (positive, 9/10 vs. negative, 14/40, p = .0031) and regional atrophy (13/14 vs. 10/36, p = .0001).There were significant relationships between the length of seizure/epilepsy history and presence of intratumoral T1-weighted high-intensity area (median 3 years vs. 0.5 years, p = .0021), stalk-like sign (13.5 vs. 1 year, p < .0001), and regional atrophy (14 vs. 0.5 years, p < .0001). Patients with brainstem AGs (n = 7) did not have a seizure/epilepsy history and were significantly younger than those with supratentorial AGs (median, 5 vs. 13 years, p < .0001, respectively).Conclusions: Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain atrophy were frequent imaging features in AG. We also found that affected age was different between supratentorial and brainstem AGs.

2021 updates to the World Health Organization classification of adult-type and pediatric-type diffuse gliomas: a clinical practice review

“…Angiocentric gliomas are rare tumors typically affecting children and younger adults with epilepsy and are considered another LEAT (44,45). They may occur in the cerebral cortex or brainstem and on imaging characteristically show a well-delineated, non-enhancing, T2-FLAIR hyperintense lesion occasionally with a stalk-like connection to the lateral ventricle (41,(46)(47)(48)(49)(50)(51). On histopathology, angiocentric gliomas are moderately cellular, diffusely infiltrating tumors composed of monomorphic spindle cells with elongated nuclei at least focally arranged in single or multiple layers around blood vessels, often in a radial pattern (45).…”

Neuroimaging features of FOXR2‐activated CNS neuroblastoma: A case series and systematic review

“…We employed a tool to evaluate the methodological quality of case reports and case series proposed by Murad et al 11 This tool comprises eight signaling questions in four domains-selection, ascertainment, causality, and reporting-and has been used in various previous casebased systematic reviews including our previous studies. [12][13][14][15][16][17]…”

Paediatric-type diffuse low-grade gliomas: a clinically and biologically distinct group of tumours with a favourable outcome

“…AG is often detected in the setting of childhood long-term and drug-resistant epilepsy surgery and therefore it has always been considered a low-grade epilepsy-associated brain tumour (LEAT), representing 0.8% (13 cases) of 1680 tumours collected from the German Neuropathology Reference Center 21 . In a recent series published by Kurokawa et al median age was 13 years old, range 2-83 years 22 .…”