Intracranial metastasis of spinal intramedullary anaplastic astrocytoma

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Abstract

Meningeal spread of spinal intramedullary astrocytoma into the cranium is rare. Only few case reports are available so far in the literature. We report a case of intramedullary high grade astrocytoma of the conus, developing intracranial metastasis after three months of partial excision of the spinal mass. The need for radical surgery, entire neuroaxis radiation, and adjuvant chemotherapy is suggested in the management of malignant spinal cord astrocytoma to prevent dissemination.

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Most cited references 16

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Value of cerebrospinal fluid cytology for the diagnosis of malignancies in the central nervous system.

J Balhuizen, F Bosman, A. Schaberg … (1978)

The authors present a retrospective analysis of the results of the cytological examinations of cerebrospinal fluid (CSF) samples and tumor-cyst aspirates deriving from 262 patients treated for malignant intracranial primary and secondary tumors, and vertebral and peridural metastastic processes. Positive preoperative CSF samples were found in 15.3% of all cases of primary cerebral malignancies (13.9% of all gliomas) and positive postoperative CSF samples were found in 40% (91% of the medulloblastoma cases). In all cases of single or multiple secondary cerebral tumors, positive preoperative CSF samples were found in 20%.

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Spinal cord pilocytic astrocytoma with leptomeningeal dissemination to the brain. Case report and review of the literature.

Gregory C. Rutledge, Taylor J. Abel, Abhineet Chowdhary … (2006)

Leptomeningeal dissemination of low-grade spinal cord gliomas is an uncommon event. The authors report a unique case of leptomeningeal dissemination of a spinal cord pilocytic astrocytoma (PCA) to the intracranial cerebral subarachnoid spaces in a child. A 2-year-old boy presented with a loss of balance and the inability to walk or stand. An intradural intramedullary spinal cord tumor was identified, and the lesion was subtotally resected and diagnosed by the pathology department to be a PCA. Subsequently, the patient had recurrences of the intradural intramedullary tumor at 6 months and 2 years after his original presentation. He underwent a repeated resection of the recurrent tumor and fenestration of an associated syrinx on both occasions. The pathological characteristics of the reresected tumor remained consistent with those of a PCA. Postoperative imaging after his last surgery revealed diffuse intracranial leptomeningeal dissemination into the cisternal space surrounding the midbrain, the suprasellar region, and the internal auditory canal, as well as nodular subarachnoid disease in the upper cervical region. The patient then underwent chemotherapy, and total spine magnetic resonance (MR) imaging 2 months later demonstrated stability in the size of the spinal cord tumor and a decrease in the associated syrinx. However, an MR image of the head demonstrated two new areas of supratentorial subarachnoid leptomeningeal spread of the primary spinal cord tumor at the 2-month follow-up examination. At the 6-month follow-up examination, MR imaging of the head and spine demonstrated stable metastatic disease. This case illustrates a unique instance of supratentorial leptomeningeal dissemination of an intramedullary spinal cord PCA in a child.

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Metastasising gliomas in young subjects.

H Urich, O Eade (1971)

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Author and article information

Journal

Journal ID (nlm-ta): Asian J Neurosurg

Journal ID (publisher-id): AJNS

Title: Asian Journal of Neurosurgery

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 1793-5482

ISSN (Electronic): 2248-9614

Publication date (Print): Jul-Dec 2011

Volume: 6

Issue: 2

Pages: 116-118

Affiliations

[1]Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India

[1 ]Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India

Author notes

Address for correspondence: Dr. Rashim Kataria, Assistant Professor (Neurosurgery), 53, Mauji Colony, Malviya Nagar, Jaipur - 302 004, Rajasthan, India. E-mail: rashim_kat@ 123456yahoo.com

Article

Publisher ID: AJNS-6-116

DOI: 10.4103/1793-5482.92179

PMC ID: 3277066

PubMed ID: 22347337

SO-VID: 3acd4bed-71ca-4ec3-90e7-85c0c3bff12d

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Intracranial metastasis of spinal intramedullary anaplastic astrocytoma

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Abstract

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Most cited references 16

Value of cerebrospinal fluid cytology for the diagnosis of malignancies in the central nervous system.

Spinal cord pilocytic astrocytoma with leptomeningeal dissemination to the brain. Case report and review of the literature.

Metastasising gliomas in young subjects.

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