A polycystic variant of a primary intracranial leptomeningeal astrocytoma: case report and literature review
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Case report
A polycystic variant of a primary intracranial leptomeningeal astrocytoma: case report and literature review Antonio De Tommasi*1, Giuseppe Occhiogrosso1, Claudio De Tommasi1, Sabino Luzzi1, Antonella Cimmino2 and Pasqualino Ciappetta1 Address: 1Department of Neurology and Neuropsychiatry Sciences, Chair of Neurosurgery, University of Bari, 70124 Bari, Italy and 2Department of Anatomical and Cellular Pathology, Chair of Pathology, University of Bari, 70124 Bari, Italy Email: Antonio De Tommasi* - [email protected]; Giuseppe Occhiogrosso - [email protected]; Claudio De Tommasi - [email protected]; Sabino Luzzi - [email protected]; Antonella Cimmino - [email protected]; Pasqualino Ciappetta - [email protected] * Corresponding author
Published: 23 June 2007 World Journal of Surgical Oncology 2007, 5:72
doi:10.1186/1477-7819-5-72
Received: 24 January 2007 Accepted: 23 June 2007
This article is available from: http://www.wjso.com/content/5/1/72 © 2007 De Tommasi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Primary leptomeningeal astrocytomas are rare intracranial tumors. These tumors are believed to originate from cellular nests which migrate by means of aberration, ultimately settling in the leptomeningeal structure. They may occur in both solitary and diffuse forms. The literature reports only fifteen cases of solitary primary intracranial leptomeningeal astrocytomas. Case presentation: The authors report the case of a seventy-eight year-old woman with a polycystic variant of a solitary primary intracranial leptomeningeal astrocytoma. The first neurological signs were seizures and aphasia. CT and MRI scans demonstrated a fronto-parietal polycystic tumor adherent to the sub arachnoid space. A left fronto-temporo-parietal craniotomy revealed a tight coalescence between the tumor and the arachnoid layer which appeared to wrap the mass entirely. Removal of the deeper solid part of the tumor resulted difficult due to the presence of both a high vascularity and a tight adherence between the tumor and the ventricular wall. Conclusion: A new case of a solitary primitive intracranial leptomeningeal astrocytoma of a rare polycystic variant is reported. Clinical, surgical, pathologic and therapeutic aspects of this tumor are discussed.
Background Moore was the first in 1954 to describe a diffuse form of a primary leptomeningeal astrocytoma (PLA) [1]. These tumors are rare and, in most cases, are associated with a poor survival. Gliomas very rarely arise from the meninges and, to date, their histogenesis remains controversial. The diffuse forms normally affect the entire leptomeninges, giving a
gliomatosis appearance and a macroscopic similarity to meningitis [2], while the solitary for
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