Cystic angiocentric glioma: a case report and literature review
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CASE REPORT
Cystic angiocentric glioma: a case report and literature review Qiqi Wang 1 & Yubo Xiong 1 & Jun Chen 1 & Qiang Shao 1 Received: 13 August 2020 / Accepted: 6 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Angiocentric glioma (AG) is a rare form of brain tumor characterized by cortical epileptogenic lesions that show angiocentric patterns upon histopathological examination. Cystoid degeneration is a rare radiological manifestation of this condition. We report a case involving the left eloquent cortical areas and review the clinical features of angiocentric glioma. A 10-year-old girl presented with a history of refractory drug-resistant epilepsy. Imaging revealed a cystic-solid neoplasm within the left frontal lobe. Surgical procedures were performed, and it was observed that the pathological manifestations were consistent with those of AG. Angiocentric glioma should be considered for diagnosis when the supratentorial cortical neoplasm contains a cystic component. The diagnosis of AG can be confirmed by histopathological examination. Gross total resection is the recommended strategy for controlling seizures elicited by this condition. Keywords Angiocentric glioma . Seizure . Low-grade glioma . Pediatric epilepsy
Introduction Angiocentric glioma (AG) was first reported in 2005 [5, 10]. Cerebral cortices are usually affected, and seizures occur quite often. Prominent therapeutic strategies include administration of anti-epileptic drugs and tumor resection. Here, we report a case that we came across.
Case report A right-handed 10-year-old girl had a history of simple partial seizures followed by secondary generalized tonic-clonic seizures over the previous year. She had been treated with antiepileptic drugs, such as oxcarbazepine and valproate, and traditional Chinese medicine. However, her seizures could not be controlled and occurred thrice a day, on an average. Results of the interictal physical examination were normal. A cranial computed tomography (CT) scan revealed a slightly hypodense lesion without calcification in the left frontoparietal lobe (Fig. 1a). Brain magnetic resonance imaging (MRI) revealed a cystic-solid, non-enhancing neoplasm * Qiang Shao [email protected] 1
Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan 430014, China
involving the cortical and subcortical white matter in the left frontal region. T1-weighted imaging (T1WI) showed a welldefined hypointense mass close to the left precentral gyrus, a low-intensity signal in the cystic area, and a slight hyperintensity deep in the lesion in the sagittal image (Fig. 1b). T2-weighted imaging (T2WI) showed hyperintensity (Fig. 1c). Fluid-attenuated inversion recovery (FLAIR) imaging revealed the lesion clearly with a size of 2.26 cm × 2.44 cm × 2.66 cm, a hyperintense solid component and hypointense cystic area, and a stalk-like neoplasm projecting toward the lateral ventricle (Fig. 1d, e). Apparent diffusion coefficient (ADC) showed no restricted diffusion (Fig. 1f)
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