Pilomyxoid astrocytoma in a patient presenting with fatal hemorrhage

Hamada, Hideo; Kurimoto, Masanori; Hayashi, Nakamasa; Nagai, Shoichi; Kurosaki, Kunikazu; Nomoto, Kazuhiro; Kanegane, Hirokazu; Nomura, Keiko; Endo, Shunro

doi:10.3171/ped/2008/1/3/244

Cited by 25 publications

(18 citation statements)

References 17 publications

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“…В обоих наблюдениях опухоль была представлена гистологическим вариантом пило-миксоидной астроцитомы (WHO Grade I-II и WHO Grade II) с ИМ Ki-67 8-10%. В научной литературе [16][17][18] мы встретились с мнением, что при поли-миксоидном типе опухоли кровоизлияния в опухоль прослеживаются чаще. Офтальмологическая сим-птоматика, характер зрительных нарушений во вто-ром нашем наблюдении свидетельствовали о пора-жении правого зрительного нерва, хиазмы и правого зрительного тракта, что нашло свое подтверждение на операции.…”

Section: Discussionunclassified

Chiasm and optic nerve glioma manifested as hemorrhage (two clinical cases and a literature review)

et al. 2016

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Section: Discussionunclassified

Chiasm and optic nerve glioma manifested as hemorrhage (two clinical cases and a literature review)

et al. 2016

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“…They have a higher rate of local recurrence following resection and have a higher risk of hemorrhage and leptomeningeal spread [8,16,20,21]. PMAs have a significantly shorter progression-free (25 compared to 163 months) and overall survival time (60 compared to 233 months) compared to age-matched PAs [8].…”

Section: Discussionmentioning

confidence: 99%

Temporal and Optic Pathway Pilomyxoid Astrocytoma Mimicking Dural-Based Lesion: Case Report and Review of the Literature

Edwards

Kulwin²,

Martin

et al. 2012

Pediatr Neurosurg

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Pilomyxoid astrocytomas (PMAs) are low-grade tumors that share many common traits with pilocytic astrocytomas. However, PMAs have a more worrisome clinical course, with a higher recurrence rate, lower survival rate, and higher risk of leptomeningeal spread compared to pilocytic tumors. These tumors tend to occur in younger children and are typically located in the area of the optic chiasm or hypothalamus. There are few studies examining the radiographic appearance of these lesions. In this case report, the authors present an unusual radiographic appearance of a PMA in an 11-year-old child. Preoperative images suggested a dural-based, homogenously enhancing lesion coupled with an enlarged optic nerve. Surgery revealed an intraparenchymal lesion of the right temporal lobe. There was hyperintensity on T2 MRI sequences, suggesting infiltration of the tumor along the optic tracts.

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“…Lesions in the hypothalamic region rarely reported to have bled are pilocytic astrocytomas, pilomyxoid astrocytomas and fibrillary astrocytomas [17,18,19,20,21,22,23]. Possible causes of tumor-related hemorrhage include endothelial proliferation and obstruction of the tumor vessels causing necrosis and hemorrhage, disruption of vessels by tumor expansion, tumor infiltration into vessels, or abnormal tumor vascularity [17,18,19,20,21,22,23,24]. Hemorrhage in a hamartoma is rare, with isolated reports in sites like the retina and intestine [25,26].…”

Section: Discussionmentioning

confidence: 99%

Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

Kiran

Ghosal²,

Thakar³

et al. 2011

Pediatr Neurosurg

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Hypothalamic hamartomas have been reported to coexist with lesions like Rathke’s cleft cyst and arachnoid cysts in the suprasellar or temporo-sylvian regions. This is the first report in indexed literature describing its association with a suprasellar teratoma. A 7-year-old girl presented with long-standing precocious puberty and generalized tonic-clonic seizures and recent-onset raised intracranial pressure. MRI done prior to the onset of symptomatic raised intracranial pressure revealed 2 distinct lesions in the suprasellar region. One was a midline, pedunculated lesion arising from the hypothalamus, with evidence of an old bleed within it. A separate lesion, with a wide base near the tuberculum sellae and a posteriorly directed conical tip, was noted in an adjacent sagittal cut. CT scan done at the time of admission demonstrated a re-bleed in the suprasellar region with blood in the lateral and third ventricles and gross hydrocephalus. The child was taken up for a ventriculoperitoneal shunt followed by complete excision of the lesions. Histopathologic examination confirmed the pedunculated lesion to be a hypothalamic hamartoma with evidence of hemorrhage, and the other to be a mature teratoma. Postoperative MRI confirmed complete excision of both the lesions. The child reported regression of precocious puberty and remained seizure-free until the last follow-up 6 months after surgery. A hypothesis based on a dysontogenetic mechanism is discussed to explain the unusual occurrence of the dual, seemingly unrelated pathologies. Hemorrhage into the hamartoma was an added oddity in this case.

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Pilomyxoid astrocytoma in a patient presenting with fatal hemorrhage

Cited by 25 publications

References 17 publications

Chiasm and optic nerve glioma manifested as hemorrhage (two clinical cases and a literature review)

Chiasm and optic nerve glioma manifested as hemorrhage (two clinical cases and a literature review)

Temporal and Optic Pathway Pilomyxoid Astrocytoma Mimicking Dural-Based Lesion: Case Report and Review of the Literature

Synchronous Occurrence of a Hemorrhagic Hypothalamic Hamartoma and a Suprasellar Teratoma

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