Pilocytic astrocytomas with leptomeningeal dissemination: biological behavior, clinical course, and therapeutical options

被引:37
作者
Buschmann, U [1 ]
Gers, B [1 ]
Hildebrandt, G [1 ]
机构
[1] Kantonsspital St Gallen, Dept Neurosurg, CH-9007 St Gallen, Switzerland
关键词
children; cerebral tumors; chemotherapy; low-grade glioma; chiasmo-hypothalamic; pilocytic astrocytoma;
D O I
10.1007/s00381-003-0746-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background. The aim of this case-based update is to discuss the biological characteristics, clinical course, and optimal treatment of pediatric patients harboring pilocytic astrocytomas (PA) with leptomeningeal dissemination (LMD). PAs are well-recognized benign pediatric tumors of the central nervous system (CNS). Despite a favorable outcome in general, in rare cases LMD might occur and contribute to poor clinical course. Localization of the PA in the chiasmo-hypothalamic region seems especially predisposed to LMD. In addition, specific histological features might constitute the potential for subarachnoid metastases. The optimal treatment is still under discussion but studies suggest that chemotherapeutical treatment should be used as first choice therapy in order to avoid or delay radiotherapy. Case reports and discussion. Two cases of subtotally resected chiasmo-hypothalamic PAs with synchronous LMD but with different rates of progression are described. The literature is reviewed and compared with our findings.
引用
收藏
页码:298 / 304
页数:7
相关论文
共 35 条
[1]   Hyaluronate receptors mediating glioma cell migration and proliferation [J].
Akiyama, Y ;
Jung, S ;
Salhia, B ;
Lee, SP ;
Hubbard, S ;
Taylor, M ;
Mainprize, T ;
Akaishi, K ;
van Furth, W ;
Rutka, JT .
JOURNAL OF NEURO-ONCOLOGY, 2001, 53 (02) :115-127
[2]   CEREBELLAR ASTROCYTOMA WITH BENIGN HISTOLOGY AND MALIGNANT CLINICAL COURSE - CASE-REPORT [J].
AUER, RN ;
RICE, GPA ;
HINTON, GG ;
AMACHER, AL ;
GILBERT, JJ .
JOURNAL OF NEUROSURGERY, 1981, 54 (01) :128-132
[3]   Pilocytic astrocytoma with subarachnoidal spread [J].
BraunFischer, A ;
Romeike, BFM ;
Eymann, R ;
Glas, B ;
Riesinger, P ;
Reiche, W .
RADIOLOGE, 1997, 37 (11) :899-904
[4]   LEPTOMENINGEAL DISSEMINATION OF OPTIC PATHWAY GLIOMAS IN 3 CHILDREN [J].
BRUGGERS, CS ;
FRIEDMAN, HS ;
PHILLIPS, PC ;
WIENER, MD ;
HOCKENBERGER, B ;
OAKES, WJ ;
BUCKLEY, EG .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 1991, 111 (06) :719-723
[5]   DOES CHEMOTHERAPY HAVE A ROLE IN LOW-GRADE ASTROCYTOMA MANAGEMENT - A REPORT OF 13 CASES [J].
CASTELLO, MA ;
SCHIAVETTI, A ;
PADULA, A ;
VARRASSO, G ;
PROPERZI, E ;
TRASIMENI, G ;
OPERAMOLLA, P ;
GUALDI, GF ;
CLERICO, A .
MEDICAL AND PEDIATRIC ONCOLOGY, 1995, 25 (02) :102-108
[6]   LEPTOMENINGEAL DISSEMINATION OF LOW-GRADE GLIOMAS IN CHILDHOOD [J].
CIVITELLO, LA ;
PACKER, RJ ;
RORKE, LB ;
SIEGEL, K ;
SUTTON, LN ;
SCHUT, L .
NEUROLOGY, 1988, 38 (04) :562-566
[7]   OPTIC PATHWAY HYPOTHALAMIC GLIOMAS - A DILEMMA IN MANAGEMENT [J].
HOFFMAN, HJ ;
HUMPHREYS, RP ;
DRAKE, JM ;
RUTKA, JT ;
BECKER, LE ;
JENKIN, D ;
GREENBERG, M .
PEDIATRIC NEUROSURGERY, 1993, 19 (04) :186-195
[8]   PROGNOSTIC IMPLICATIONS OF THE PROLIFERATIVE POTENTIAL OF LOW-GRADE ASTROCYTOMAS [J].
HOSHINO, T ;
RODRIGUEZ, LA ;
CHO, KG ;
LEE, KS ;
WILSON, CB ;
EDWARDS, MSB ;
LEVIN, VA ;
DAVIS, RL .
JOURNAL OF NEUROSURGERY, 1988, 69 (06) :839-842
[9]  
Jamjoom AB, 1998, BRIT J NEUROSURG, V12, P56
[10]   A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European organization for research and treatment of cancer (EORTC) study 22844 [J].
Karim, ABMF ;
Maat, B ;
Hatlevoll, R ;
Menten, J ;
Rutten, EHJM ;
Thomas, DGT ;
Mascarenhas, F ;
Horiot, JC ;
Parvinen, LM ;
vanReijn, M ;
Hamers, HP ;
Gaspar, L ;
Noordman, E ;
Pierart, M ;
vanGlabbeke, M ;
vanAlphen, AM ;
Jager, JJ ;
Fabrini, MG .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1996, 36 (03) :549-556