Samples Derek C, Henry James, Yu Fang Frank, Bazan Carlos, Tarasiewicz Izabela
Department of Neurological Surgery, University of Texas Health Science Center, San Antonio, Texas, USA.
Department of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA.
Surg Neurol Int. 2016 Dec 12;7(Suppl 40):S1008-S1012. doi: 10.4103/2152-7806.195583. eCollection 2016.
Astroblastoma is a rare neuroepithelial tumor that often originates in the cerebral hemisphere of children and young adults. Diagnosis of this obscure neoplasm can be difficult because these tumors are so infrequently encountered and share common radiological and neuropathological features of other glial neoplasms. As such, it should be included in the differential diagnosis of astrocytoma and ependymoma if the clinical and radiographic features suggest it. Standardized treatment of astroblastomas remains under dispute because of the lack of knowledge regarding the tumor and a paucity of studies in the literature.
We present a case of a low-grade astroblastoma diagnosed in a 30-year-old female with seizures, headache, and vision changes. She underwent gross total resection and, without evidence of high-grade features, adjuvant therapy was not planned postoperatively. Post-operative surveillance suggested early recurrence, warranting referral to radiation therapy. Patient ended up expiring despite adjuvant therapy secondary to extensive recurrence and tumor metastasis.
Astroblastoma must be considered in the differential of supratentorial tumors in children and young adults. Treatment of such, as suggested by most recent literature, includes gross total resection and adjuvant radiotherapy for lesions exhibiting high-grade features.
星形母细胞瘤是一种罕见的神经上皮肿瘤,常起源于儿童和年轻成人的大脑半球。这种难以诊断的肿瘤的诊断可能很困难,因为这些肿瘤很少见,并且与其他胶质肿瘤具有共同的放射学和神经病理学特征。因此,如果临床和影像学特征提示,应将其纳入星形细胞瘤和室管膜瘤的鉴别诊断中。由于对该肿瘤缺乏了解且文献中研究较少,星形母细胞瘤的标准化治疗仍存在争议。
我们报告一例30岁女性低级别星形母细胞瘤病例,患者有癫痫发作、头痛和视力改变。她接受了肿瘤全切术,由于没有高级别特征的证据,术后未计划辅助治疗。术后监测提示早期复发,因此转诊接受放射治疗。尽管进行了辅助治疗,但患者最终因广泛复发和肿瘤转移而死亡。
在儿童和年轻成人幕上肿瘤的鉴别诊断中必须考虑星形母细胞瘤。根据最新文献,此类肿瘤的治疗包括对具有高级别特征的病变进行肿瘤全切和辅助放疗。