Superficial cerebral astrocytoma attached to dura: Report of six cases in infants

Abstract

Reported are six cases of meningocerebral astrocytomas attached to dura, involving the superficial cortex, in infants under 1 year of age. They represent 1.25% of 483 intracranial tumors in infancy studied at the Children's Hospital in the last 12 years. Five were located in the frontal lobes, with variable extension to the parietal or the parietotemporal regions, and one was located in the parietal lobe. They were all composed of a solid portion and one or more cysts, and they measured approximately 6 to 12 cm in diameter. They had spindle cells, some more plump, arranged in areas in a storiform pattern. Tumors were very rich in reticulin fibers, mimicking a mesenchymal tumor. There was very slight pleomorphism. Bizarre giant cells were not observed and lipidization was not a prominent feature. Immunoperoxidase technique was performed in all of them and showed glial fibrillary acidic protein (GFAP) in most of the tumor cells. We believe their origin is from subpial astrocytes. They probably represent a separate entity whose diagnosis cannot be accurately established without immunohistochemical techniques.

The correlation of neoplastic vulnerability with central neuroepithelial cytogeny and glioma differentiation

“…By electron microscopy the neoplastic glial cells frequently display a pericytoplasmic basal lamina which is characteristic of subpial cerebral astrocytes. This group of tumors is in all likelihood identical with those examples, also restricted to infants, that have been described as superficial cerebral astrocytomas and are characterized by a similarly intense desmoplasia (90).…”

“…The massive size of these tumors, which may perhaps most conveniently be termed 'desmoplastic infantile gangliogliomas', certainly points to their pre-or perinatal development. From the clinical viewpoint, their histological recognition as a distinct entity is of prognostic significance because, as both series reported so far (89,90) indicate, successful complete or subtotal resection of these growths has, despite their voluminous size, been followed by a favorable postoperative course: in some cases this has extended over several years of tumor-free survival. We therefore have here a type of mixed neurogliogenic tumor of early life whose biological behavior makes it more akin to the gangliogliomas than to the less differentiated forms of embryonal CNS tumor.…”

Desmoplastic infantile astrocytoma with multiple intracranial and intraspinal localizations at presentation

“…Desmoplastic infantile glioma, described first in 1984 by Taratuto et al [18], is a rare tumor which presents most often as a large hemispheric mass [9]. These tumors usually occur in infants aged between 1 and 24 months with a male/female ratio of 1.7/1.0 [4].…”

Desmoplastic infantile ganglioglioma ? clinicopathological and immunohistochemical study of four cases

“…Desmoplastic infantile ganglioglioma is an uncommon, relatively recently described, neoplasm [25] This tumour stands out as unique amongst other neuroepithelial tumours because of its superficial, dura-based location in the cerebral hemispheres, its characteristic histological appearance and its occurrence in infancy [5,10,19]. Of the 25 reported cases of DIG reviewed by Duffner et al [5] all but 1 were in children less than 1 year of age.…”