Pilocytic astrocytoma with leptomeningeal dissemination

Abstract

Treatment of disseminated PA is frequently multi-modal, including surgical resection, chemotherapy, and radiation therapy. On the basis of early clinical data, extended-field radiation therapy is a viable option for treating disseminated PA.

Leptomeningeal dissemination of spinal pilocytic astrocytoma: a rare entity

“…PA is primarily treated with surgery, and occasionally, with radiotherapy and/or chemotherapy, while targeted therapies hold promise. Prognosis is excellent; with 10-year survival >90%, falling to <50% for patients with LD 4. As this case demonstrates however that despite LD, these patients can still have a relatively long and indolent course.…”

“…There is a possibility that it represents a distinct entity or has a specific phenotype; however, this will need further analysis. While LD can present with hydrocephalus, many are identified incidentally 4. Since the number of known LD are very low, there are no known factors described to suggest its occurrence; however, any change in the neurological status and any clinical suspicion of raised intracranial pressure should prompt further imaging to exclude its occurrence.…”

Manifestations of pilocytic astrocytoma: a pictorial review

“…However, less common appearances are quite nonspecific. A feature specific of this benign neoplasm is that in many cases it displays histological and imaging features that are commonly seen in higher grade neoplasms and appear incongruous for a slow-growing brain tumour with fairly bland histological characteristics, such as microvascular proliferation, infiltration of surrounding tissues and structures, intratumoral haemorrhage, intense enhancement on post-contrast images, and leptomeningeal dissemination [2, 9, 11–13]. …”

Heterogeneity of histopathological presentation of pilocytic astrocytoma – diagnostic pitfalls. A review

“…Deeply situated lesions can be only partially resected. Disseminated PA lesions are usually treated by multi-modal therapy, including surgical resection, chemotherapy, and radiotherapy with extended-field radiation [16]. It is noteworthy that PAs are generally indolent tumours and attention should be paid to avoiding aggressive therapy [80].…”