Multifocal pilocytic astrocytomas with ependymal differentiation in the bilateral medial temporal lobes: case report.

Abstract:

:A 7-year-old boy presented with headache, visual disturbance, and psychomotor seizures persisting for 7 months. He had mild hemiparesis and homonymous hemianopia on the left. Neuroimaging showed bilateral temporal lobe masses with calcification and cysts. The right temporal mass was subtotally resected. The histological diagnosis was pilocytic astrocytoma with ependymal differentiation and a MIB-1 staining index of up to 8.0%. Postoperatively his hemiparesis and psychomotor seizures disappeared. Adjuvant chemotherapy consisting of carboplatin and vincristine was given followed by radiotherapy. Neuroimaging showed that the bilateral tumors had disappeared and showed no recurrence for 29 months after the diagnosis. Pilocytic astrocytoma usually presents as a solitary mass in the cerebellum or optic pathway with low proliferative activity, but should be included in the differential diagnosis of multifocal tumors arising in the bilateral temporal lobes. Ependymal differentiation with extremely high proliferative activity might be related to this unusual clinical presentation. Intensive treatment is recommended for patients with such specific neuroimaging and histological features.

authors

Maruyama K,Morita A,Shibahara J,Nakazato Y,Kirino T

doi

10.2176/nmc.45.411

keywords:

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

411-4

issue

8

eissn

0470-8105

issn

1349-8029

pii

JST.JSTAGE/nmc/45.411

journal_volume

45

pub_type

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