Astrocytoma Presenting Research Articles

Bilateral Thalamic Astrocytoma Presenting as Depression and Cognitive Impairment

The thalamus is the relay site for most afferent pathways. Thalamic lesions cause mental symptoms such as depressive symptoms, anxiety, poor attention and concentration, and memory disturbances. This case report describes a 35-year-old female patient who presented with sadness, disinterest in daily activities, anxiety, crying spells, and other mental symptoms. On detailed inquiry, she was also found to have reduced attention, concentration, and short-term memory disturbances, with no focal neurological deficit on examination. Imaging with magnetic resonance imaging brain revealed a bilateral thalamic low-grade astrocytoma. This case demonstrates that a careful understanding of the apathy and cognitive dysfunction in the presence of depression/anxiety is consequential. In this case, there is more to the clinical presentation of the symptoms of depression and anxiety than meets the eye. The expressionless face, apathy, and a certain degree of unawareness mark out the familiar depressive and anxiety symptoms from cognitive decline seen in thalamic lesions.

Atypical Presentation of a Pilocytic Astrocytoma at the Regional Hospital of Ségou in Mali country

Introduction: Pilocytic astrocytoma is the most common cerebral glioma in pediatric age, preferentially located in the posterior cerebral fossa. Atypical presentations have rarely been described in the literature. Clinical Case: We report a case of pilocytic astrocytoma whose appearance on CT scan is unusual. It concerns a young boy of 9 years old, who presented convulsive seizures since the age of 6 years old, followed by general practitioners with irregular treatment based on gardenal. 2 months ago the seizures became more frequent and this prompted a specialist consultation with the neurologist, after a brain scan he referred the patient to us. The neurological examination was unremarkable today. Brain CT with contrast showed a right parietal lesion. It was a lesion with a double cystic and fleshy component associated with calcifications with heterogeneous enhancement which amputated the posterior horn of the lateral ventricle. The radiological appearance was in favor of a low-grade oligodendroglioma. The patient underwent surgery with complete macroscopic excision of the lesion. Histological examination revealed a pilocytic astrocytoma (grade I). Conclusion: The usual radiological appearance of pilocytic astrocytoma combines a cystic part and a highly contrasting mural nodule. It rarely presents in the form of a supratentorial lesion with calcifications. This form of presentation is rare and can lead to confusion with other gliomas. We can achieve healing for the patient with total excision.

Atypical presentation of a high-grade astrocytoma in a pediatric rheumatology Practice

Introduction. Hip pain is common in childhood. The main dilemma is to differentiate between benign conditions and those causing significant morbidity and mortality.
 Material and methods. A clinical case report of a toddler presenting with Musculoskeletal (MSK) mask due to a brain tumor.
 Results. A 2-year-old boy presented to the ER complaining of hip pain, muscle weakness, and limping. The neurologic exam showed no abnormalities. At the 3rd day of admission, patient condition worsened, and papillary edema was revealed. MRI revealed a tumor in the suprasellar cistern/prepons region. 
 Conclusions. In case of atypical MSK symptoms, a careful evaluation of children should be carried out to prevent any delay in diagnosis.

Poster 447: Possible Pilocytic Astrocytoma Presenting as Migraines and Bilateral Cervical Myalgia in Adulthood: A Case Report

Poster 447: Possible Pilocytic Astrocytoma Presenting as Migraines and Bilateral Cervical Myalgia in Adulthood: A Case Report

Anaplastic Astrocytoma Presenting as Ischemic Stroke: A Diagnostic Pitfall

Anaplastic Astrocytoma Presenting as Ischemic Stroke: A Diagnostic Pitfall

脳卒中症状にて発症したびまん性星細胞腫の1例

脳卒中症状にて発症したびまん性星細胞腫の1例

Anaplastic Astrocytoma Presenting as Herpes Simplex Encephalitis

Anaplastic Astrocytoma Presenting as Herpes Simplex Encephalitis

Unusual presentation of unilateral intra-orbital optic nerve pilocytic astrocytoma of the juvenile type in a geriatric patient

Optic nerve gliomas (ONG) are rare and seldom encountered in clinical practice. The pilocytic (astrocytoma) variant of ONG almost always presents during the first two decades of life. In this report, the authors discuss an unusual presentation of pilocytic astrocytoma of the juvenile type in an elderly Indian male. With this unusual presentation, ONG affecting the visual pathway should be considered as a possible differential of visual diminution in the elderly population.

Low-grade astrocytoma presenting as brain stone

Summary This paper presents the case of a 21-year-old male patient with a history of generalized tonic–clonic seizure induced by an almost completely and densely calcified intra-axial tumor located at the left frontal lobe. The tumor exhibited an unpublished combination of extensive ossification and calcification with minimal cytologic atypia and positive findings for glial fibrillary acidic protein. The final diagnosis was that of an intracerebral low-grade astrocytoma (LGA). Reports of this tumor are extremely rare. We review similar cases, the mechanisms of tumor calcification, and the current treatment for LGAs.

Pilocytic astrocytoma presenting with atypical features on magnetic resonance imaging

Pilocytic astrocytoma, which is classified as a grade I astrocytic tumor by the World Health Organization, is the most common type of glioma in children and young adults. Pilocytic astrocytoma generally appears as a well-circumscribed, contrast-enhancing lesion, frequently with cystic components on magnetic resonance imaging (MRI). However, it has been reported that the MRI appearance of pilocytic astrocytoma may be similar to that of high-grade gliomas in some cases. We here report on 6 cases of pilocytic astrocytoma with atypical MRI findings, including small cyst formation, heterogeneously enhancing tumor nodules, irregularly enhancing tumor nodules, and enhancing tumor nodules with internal hemorrhage. All tumors were successfully resected, and the histological diagnoses were pilocytic astrocytoma. When the tumor is located near a cerebral cistern or ventricle, the risk of leptomeningeal dissemination is increased. Furthermore, partial resection has also been associated with a higher risk of recurrence and leptomeningeal dissemination. To date, all but one patient are alive and recurrence-free. Because the preoperative diagnosis influences the decision on the extent of resection and because of the high risk of leptomeningeal dissemination associated with these tumors, careful and correct diagnosis by MRI is important.

Cerebellar Astrocytoma Presenting with Headache and Nystagmus in a 20-Year-Old Male

Cerebellar Astrocytoma Presenting with Headache and Nystagmus in a 20-Year-Old Male

Intramedullary Astrocytoma Presenting As Cervical and Upper Back Pain: A casereport

Intramedullary Astrocytoma Presenting As Cervical and Upper Back Pain: A casereport

An Anaplastic Astrocytoma Presenting as Worsening Paresis in an Incomplete Paraplegic Patient: A Case Report

PM&RVolume 5, Issue 9S p. S256-S256 Neurological Rehabilitation An Anaplastic Astrocytoma Presenting as Worsening Paresis in an Incomplete Paraplegic Patient: A Case Report Anthony Esposito Osteopathic Medicine, Anthony Esposito Osteopathic Medicine University of Miami, Miami, FL, United StatesSearch for more papers by this authorJackson Cohen MD, Jackson Cohen MD University of Miami, Miami, FL, United StatesSearch for more papers by this authorKevin Dalal MD, Kevin Dalal MD University of Miami, Miami, FL, United StatesSearch for more papers by this author Anthony Esposito Osteopathic Medicine, Anthony Esposito Osteopathic Medicine University of Miami, Miami, FL, United StatesSearch for more papers by this authorJackson Cohen MD, Jackson Cohen MD University of Miami, Miami, FL, United StatesSearch for more papers by this authorKevin Dalal MD, Kevin Dalal MD University of Miami, Miami, FL, United StatesSearch for more papers by this author First published: 17 September 2013 https://doi.org/10.1016/j.pmrj.2013.08.427Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume5, Issue9SSeptember 2013Pages S256-S256 RelatedInformation

Parenchymal Anaplastic Astrocytoma Presenting With Visual Symptoms Due to Bilateral Optic Nerve Sheath Involvement

A 23 year old man presented with transient visual obscurations and was found to have optic nerve edema and a thalamic lesion that did not enhance on magnetic resonance imaging. Lumbar puncture opening pressure was normal. Subsequent magnetic resonance images demonstrated optic nerve sheath enhancement. Pathological diagnosis of the thalamic mass was anaplastic astrocytoma (WHO grade III). Visual symptoms were attributed to spread of high grade parenchymal glioma to the optic nerve sheaths causing intraorbital optic nerve compression.

Spontaneous Thalamic Hemorrhage as the First Presentation of Anaplastic Astrocytoma

The purpose of the study was to heighten awareness of anaplastic astrocytoma and the incidence of tumor apoplexy. A 47-year-old man with spontaneous thalamic hemorrhage as the first presentation of anaplastic astrocytoma was studied. Examination of the biopsy specimen revealed an anaplastic astrocytoma (WHO grade 3). Anaplastic astrocytoma rarely occurs as the first presentation in the thalamus with spontaneous intracranial hemorrhage. Misdiagnosis of tumor as stroke more commonly occurs in patients with a vascular risk factor, but with no history of neoplasia.

Anaplastic astrocytoma masquerading as hemorrhagic stroke

Although primary and metastatic brain tumors can cause intracranial hemorrhage, thalamic hemorrhage as the first presentation of an anaplastic astrocytoma has not been reported. We report a 47-year-old man who first presented with hypertensive hemorrhagic stroke. He improved with aggressive blood pressure control and recovered with minimal residual deficit within 10days. This led to the initial misdiagnosis of uncontrolled hypertension as the cause of the stroke. He deteriorated rapidly 4months later. A biopsy revealed an anaplastic astrocytoma. Misdiagnosis of tumor as stroke can occur in patients with vascular risk factors who do not have a previous history of neoplasia. Our case report is to heighten the awareness of the incidence of tumor apoplexy masquerading as stroke.

Acquired auditory neuropathy spectrum disorder in a child with a brain tumour

We present a case of unilateral acquired auditory neuropathy spectrum disorder (ANSD) due to an underlying cerebellar neoplasm. This is the third case in the literature of juvenile pilocytic astrocytoma presenting with auditory symptoms and mimicking the presentation of ANSD; it highlights the importance of imaging in acquired auditory neuropathy. We were able to make a diagnosis of acquired ANSD in our patient because he had a normal AABR in addition to his OAEs as part of his newborn hearing screen. Detailed neuro-otological assessment and radiological imaging is recommended in all cases of acquired ANSD in order to exclude an acquired compressive pathology.

Presentation, management, and outcome of elderly patients with newly-diagnosed anaplastic astrocytoma

Few studies have assessed the presentation, management, and outcome of anaplastic astrocytoma (AA) in elderly patients in the temozolomide era. We retrospectively reviewed 42 consecutive patients aged >65 years with newly-diagnosed AA who underwent surgical resection or biopsy between 2003 and 2008. Median age and KPS score were 73 years (range, 66-88) and 80 (range, 50-90), respectively. Thirty-two patients (76 %) presented with focal deficits. Twenty patients (48 %) experienced seizures before surgery. Tumor enhanced diffusely in 24 patients (57 %) and sparsely in 18 patients (43 %). Biopsy (79 %) was more common than resection. Post-operatively, new persistent neurological deficits and hemorrhage were seen in two (4.8 %) and three (7.1 %) patients, respectively. Complete follow-up data regarding adjuvant treatment was available in 31 patients. Sixteen patients (52 %) received temozolomide and radiation therapy (RT), while nine patients (29 %) received RT alone. Chemotherapy-related grade 3/4 hematologic complication rate was 17.6 %. Median overall survival (OS) was 6.5 months (12 months with resection; 3.5 months with biopsy). Resection (P = 0.007, risk ratio = 0.21) and sparse enhancement (P = 0.007, risk ratio = 0.13) were associated with longer OS in multivariate analysis. Similarly, chemoradiation was associated with longer survival compared to RT alone (OS: P = 0.01, progression-free survival (PFS): P = 0.02) after adjusting for age, KPS, enhancement, and surgery. Resection was associated with longer survival among elderly patients with AA, although this could reflect selection bias. Similarly, adding chemotherapy to RT was associated with prolonged survival but carried important complication risks. In appropriately selected AA patients, aggressive treatments with radical resection and chemoradiation may be appropriate even in this age group.

Levetiracetam-Induced Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome

To describe a case of levetiracetam-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. A 31-year-old white male with a low-grade astrocytoma presenting with tonic-clonic seizures was treated with levetiracetam 1 g twice daily and dexamethasone (initial dosage 12 mg/day, tapered down to 2 mg/day). On day 45 after levetiracetam initiation, dexamethasone was discontinued and levetiracetam continued. The patient developed fever and dyspnea on day 46 and was admitted to the hospital on day 49. A chest X-ray showed bilateral pulmonary interstitial infiltrates, and laboratory tests showed elevated lactate dehydrogenase (LDH; 288 U/L [reference range <204]), ferritin (223 ng/mL [13-178]), and C-reactive protein (CRP; 3.1 mg/dL [<0.5]). Neurologic fever was suspected and the reinitiation of dexamethasone at 6 mg/day was followed by improvement of all symptoms; the patient was discharged on day 55 with dexamethasone 4 mg/day for 2 more days. On day 59, 2 days after the withdrawal of dexamethasone for the second time, the patient presented with a pruritic erythematous maculopapular rash along with recurrence of fever and dyspnea, and was admitted to the hospital. A chest X-ray showed reappearance of the bilateral pulmonary interstitial infiltrates, and laboratory tests showed impaired liver function (alanine aminotransferase 60 U/L [reference range <56], aspartate aminotransferase 53 U/L [<30], LDH 516 U/L, ferritin 419 ng/mL, and CRP 2.6). A diagnosis of DRESS syndrome was suspected and levetiracetam was discontinued. Upon levetiracetam withdrawal, the patient's symptoms resolved by day 66, and radiological images showed resolution of the interstitial infiltrate by day 68. The patient was discharged on day 68. Low-grade fever persisted until day 71, with no other symptoms. During a 2-month follow-up period, liver function test results returned to normal. DRESS is a hypersensitivity reaction to several drugs, mainly antiepileptic drugs (AEDs), characterized by cutaneous, hematologic, and visceral involvement. Levetiracetam is structurally and pharmacologically unrelated to other AEDs. Previously, only one case of levetiracetam-induced DRESS syndrome had been reported, which required corticosteroids to control symptoms. We describe a case of levetiracetam-induced DRESS syndrome presenting with pneumonitis and hepatitis that resolved with levetiracetam withdrawal. Our patient was classified as a definitive DRESS case according to the RegiSCAR scoring system, which grades DRESS cases. According to the Naranjo probability scale, the adverse drug reaction was considered probable. Although levetiracetam is usually well tolerated, clinicians should be aware of the potential for it to cause DRESS syndrome.

Primary spinal cord astrocytoma presenting as intracranial hypertension: a case report.

Increased intracranial pressure (IICP) is rarely seen in association with primary spinal tumors. We describe a 58-year-old man who was diagnosed with a primary spinal cord astrocytoma, who first presented with hypesthesia, followed by intracranial hypertension, papilledema and blurred vision. On first admission, he presented with hypesthesia but without paraparesis, headache or blurred vision. Spinal MRI showed a relatively well-enhanced solid mass with a cystic portion at the cervico-thoracic level, shown histologically to be a grade I pilocytic astrocytoma. After gross total resection of the tumor, the patient had no significant neurological changes. Nine months later, the patient was admitted with headache, blurred vision and paraparesis. An ophthalmologic examination showed papilledema and lumbar tapping revealed IICP. A spinal MRI showed recurrence of the tumor which was found to be a glioblastoma after reexplorative debulking surgery. After resection, his headaches and blurred vision improved, but his paraparesis did not. These findings show that a primary spinal cord astrocytoma may cause IICP.