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Balkan Medical Journal Jun 2020
Topics: Antineoplastic Agents, Alkylating; Antineoplastic Agents, Immunological; Bevacizumab; Headache; Humans; Magnetic Resonance Imaging; Male; Neoplasms, Neuroepithelial; Radiotherapy; Temozolomide; Young Adult
PubMed: 32212579
DOI: 10.4274/balkanmedj.galenos.2020.2019.11.39 -
Clinical Neuropathology 2023Astroblastoma is an uncommon tumor of the central nervous system. It is variable in morphology, but the astroblastic pseudorosettes and vascular hyalinization are the... (Review)
Review
Astroblastoma is an uncommon tumor of the central nervous system. It is variable in morphology, but the astroblastic pseudorosettes and vascular hyalinization are the most important features. Most astroblastomas occur in the cerebral hemisphere. We report a recurrent high-grade astroblastoma with fusion in the spinal cord. Two lesions were found in the T5-7 level and T12-L1 level, and they were well defined in images. Rhabdoid and signet-ring-like cells were observed. It may be classified as a high-grade tumor due to cellularity, high mitotic count, and pleomorphism. The tumor cells were diffusely positive for GFAP, Olig-2, and S-100 protein. We found the MN1 arrangement and the loss of chromosome 1p by FISH, and further validated the BEN domain containing 2 genes (), which is the fusion partner of meningioma 1 gene (), by next-generation sequencing (NGS) and Sanger sequencing. The mutation is crucial in the diagnosis and prognosis of rare astroblastoma. The spinal cord astroblastoma may have a high recurrence rate because of the residual lesion at the unique location and higher grade; the connection with the gene mutation is unclear. Regular follow-up is necessary. Further study and more cases are needed to establish evidence for diagnosis, prognosis, and treatment of astroblastoma with molecular characteristics.
Topics: Humans; Brain Neoplasms; Meningioma; Spinal Cord; Neoplasms, Neuroepithelial; Meningeal Neoplasms; Trans-Activators; Tumor Suppressor Proteins
PubMed: 36366964
DOI: 10.5414/NP301497 -
Romanian Journal of Morphology and... 2018Astroblastoma is a poorly defined central nervous system (CNS) tumor, included along with polar spongioblastoma and gliomatosis cerebri in the group of neuroepithelial... (Review)
Review
BACKGROUND
Astroblastoma is a poorly defined central nervous system (CNS) tumor, included along with polar spongioblastoma and gliomatosis cerebri in the group of neuroepithelial tumors of uncertain origin in the June 2016 World Health Organization (WHO) Classification of tumors of the CNS. They are rare neoplasms that affect primarily patients of young ages. The purpose of this research is to highlight the uniqueness and rareness of this pathology and to emphasize on the particularities of one case managed in our Clinic.
CASE DESCRIPTION
We present the case of a 54-year-old patient with a history of seizures since the age of six years old, who presented on admission with progressive worsening and unresponsiveness to treatment, starting six months prior to presentation. Brain imaging shows a right frontal mass compressing neighboring structures. Gross total resection of the tumor was performed, and histopathological examination of the surgical sample together with immunohistochemistry highlighted the presence of a low-grade astroblastoma.
CONCLUSIONS
We summarized data from the literature in order to highlight aspects of this affliction: clinical presentation, imagery, surgical treatment and pathology, hoping that this will aid physicians in finding useful information on this subject, which can guide them to a good outcome. We also discussed differential diagnosis, as this type of tumor shares common features with ependymoma, meningioma, astrocytoma, etc.
Topics: Brain Neoplasms; Cell Proliferation; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Neoplasm Proteins; Neoplasms, Neuroepithelial
PubMed: 30845307
DOI: No ID Found -
Journal of Medical Case Reports Apr 2018Astroblastoma is a controversial and an extremely rare central nervous system neoplasm. Although its histogenesis has been clarified recently, controversies exist... (Review)
Review
BACKGROUND
Astroblastoma is a controversial and an extremely rare central nervous system neoplasm. Although its histogenesis has been clarified recently, controversies exist regarding its cellular origin and validity as a distinct entity. Because of its extreme rarity and because its common features are shared with other glial neoplasms, this tumor is prone to misdiagnosis and remains challenging not only in terms of diagnosis and classification but also in the subsequent management. This case report describes a new case of astroblastoma. It discusses clinical, radiologic, pathological, and therapeutic features and differential diagnosis of this rare neoplasm, with a review of the recent literature.
CASE PRESENTATION
We report the case of an 8-year-old Moroccan girl who presented with a 1-year history of epileptic seizure, headache, and decreased visual acuity. Cranial magnetic resonance imaging revealed a right occipito-temporal mass. A tumor resection was performed and histological examination combined with immunohistochemical study confirmed the diagnosis of low-grade astroblastoma.
CONCLUSIONS
Astroblastoma is a very rare primary brain tumor. Its diagnosis is often challenging because of the astroblastic aspects that can be found in astrocytic tumors, in ependymomas, and in non-neuroepithelial tumors. Considerable confusion surrounds its histogenesis and classification. The low incidence rate makes it difficult to conduct studies to examine tumor characteristics.
Topics: Brain Neoplasms; Child; Diagnosis, Differential; Female; Glioblastoma; Headache; Humans; Magnetic Resonance Imaging; Neoplasms, Neuroepithelial; Seizures
PubMed: 29678196
DOI: 10.1186/s13256-018-1623-1 -
Turkish Neurosurgery 2016Astroblastoma is a rare and distinct type of aggressive glial tumor for which there is much confusion regarding the diagnostic criteria. We present a case of... (Review)
Review
Astroblastoma is a rare and distinct type of aggressive glial tumor for which there is much confusion regarding the diagnostic criteria. We present a case of astroblastoma and review all relevant literature, aiming to discuss astroblastoma from the clinical, pathological, management, and prognostic points of view in an attempt to discover more of its secrets and to introduce a standard approach to its diagnosis and management.
Topics: Adult; Brain Neoplasms; Female; Humans; Male; Neoplasms, Neuroepithelial
PubMed: 27349390
DOI: 10.5137/1019-5149.JTN.9408-13.2 -
Clinical Neurology and Neurosurgery Oct 2014Astroblastoma is a rare, mostly supratentorial glial tumor, occurring predominantly in children and young adults with female preponderance. Due to the rarity, with only... (Review)
Review
Astroblastoma is a rare, mostly supratentorial glial tumor, occurring predominantly in children and young adults with female preponderance. Due to the rarity, with only about 230 reported cases, treatment strategies are still to be discussed. We describe two more cases to add to the clinical experiences with this tumor entity. In both of these cases, the clinical behavior did not follow the expectations based on histopathological classification. Case 1: A sixteen-year old female presented with a six month history of intermittent headaches, nausea and dizziness. MRI scans revealed a left parietooccipital mass lesion with bubbly contrast enhancement and marked peritumoral edema. After gross total tumor resection the histology gave the diagnosis of low grade astroblastoma. Fifteen months later, the patient was operated on a local recurrence and received postoperative radiotherapy, with the histology still being that of low grade astroblastoma. Two years later, a meningeally based tumor nodule frontal of the former tumor bed was removed, now diagnosed as high grade astroblastoma. Eighteen months later, a fourth operation with excision of two more meningeally based tumor nodules of high-grade astroblastoma followed. Chemotherapy was suggested, but the patient decided against it. The last MRI follow-up 14 months after last operation showed no further recurrence so far. Case 2: A 24-year old female presented with a four week history of vomiting and headaches with focal seizures affecting her left arm. CT and MRI scans revealed a superficial partly cystic right temporal mass lesion with few edema and macrocalcifications and adjacent bone atrophy. Despite dural invasion, total tumor resection could be performed. MRI scans six months later showed no recurrence. The patient refused further MRI controls but did not show any clinical signs or symptoms suggesting tumor recurrence four years after the operation. In order to find more predictive tools that might help to determine the individual clinical course and treatment, we performed a review of the literature, analyzing 29 cases with detailed data on clinical history, MRI/CT characteristics, histopathological subtyping, treatment details and a follow-up of at least 12 months. We found, that low-grade astroblastoma with marked peritumoral edema has a tendency to early recurrence and suggest that it should be treated by combined surgery and radiotherapy. In high-grade astroblastoma with well defined tumor borders and few peritumoral edema, the prognosis may be better than expected for a high-grade glioma, if GTR is possible.
Topics: Adolescent; Brain; Brain Neoplasms; Female; Glioma; Humans; Neoplasm Recurrence, Local; Neoplasms, Neuroepithelial; Treatment Outcome; Young Adult
PubMed: 25108699
DOI: 10.1016/j.clineuro.2014.07.013 -
Child's Nervous System : ChNS :... Jul 2019A 4-year-old girl presented to the hospital with a progressive headache, difficulty walking, and persistent daily vomiting for 3 weeks. Papilledema was observed on... (Review)
Review
A 4-year-old girl presented to the hospital with a progressive headache, difficulty walking, and persistent daily vomiting for 3 weeks. Papilledema was observed on fundoscopic examination. A large left cerebellovermian tumor with "bubbly" appearance was discovered. Total removal of the tumor mass was performed, and a diagnosis of low-grade astroblastoma was made. Adjuvant radiotherapy was performed due to the risk of recurrence. The patient is disease-free and has been kept on close follow-up for 6 months. The occurrence of posterior fossa astroblastoma has been rarely reported in the literature. Thus, when a "bubby" appearance enhancing cystic solid tumor is located on the cerebellar hemisphere in a child, an astroblastoma should also be included in the differential diagnosis.
Topics: Child, Preschool; Diagnosis, Differential; Female; Humans; Infratentorial Neoplasms; Magnetic Resonance Imaging; Neoplasms, Neuroepithelial; Treatment Outcome
PubMed: 30859299
DOI: 10.1007/s00381-019-04113-3 -
Journal of Neurosurgery. Pediatrics Feb 2008Astroblastoma is a rare primary brain neoplasm that accounts for 0.45-2.8% of brain gliomas. Intraventricular localization is extremely rare. The authors report a case... (Review)
Review
Astroblastoma is a rare primary brain neoplasm that accounts for 0.45-2.8% of brain gliomas. Intraventricular localization is extremely rare. The authors report a case of well-differentiated completely intraventricular astroblastoma in a 6-year-old girl and review the relevant literature. Their patient presented with a 5-week history of progressive nausea and vomiting. Magnetic resonance (MR) imaging revealed a large, well-demarcated, solid-cystic mass in the left temporooccipital ventricular horn. Macroscopic radical resection of the tumor was performed via the superior temporal sulcus. The postoperative course was uneventful and no adjuvant therapy was administered after surgery. No recurrence was detected at 9-months follow-up. Gross-total resection has the greatest impact on patient survival. In differentiated tumors, recurrence is usually local, and adjuvant therapy is recommended after repeated resection for the treatment of recurrence. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. It is important to distinguish astroblastoma from ependymoma in clinical practice because of the differences in therapeutic approaches.
Topics: Cerebral Ventricle Neoplasms; Child; Craniotomy; Electrocoagulation; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Microsurgery; Neoplasms, Neuroepithelial
PubMed: 18352788
DOI: 10.3171/PED/2008/1/2/152 -
Brain Tumor Pathology Jul 2019Astroblastomas are unique tumours with unresolved issues in terms of their origin, molecular biology, clinical behaviour, and response to treatment. To decipher the... (Review)
Review
Astroblastomas are unique tumours with unresolved issues in terms of their origin, molecular biology, clinical behaviour, and response to treatment. To decipher the characteristics of this tumour, we reviewed cases histologically diagnosed as astroblastoma in our institute over the past 8 years, with immunohistochemistry, and performed fluorescence in situ hybridisation (FISH), for the newly emerged MN1 rearrangement which was reported in central nervous system high-grade neuroepithelial tumours. The mean age at diagnosis was 18.6 years with all cases seen in females and with supratentorial localisation. The tumours showed typical circumscription and bubbly appearance on imaging. The cohort included eight cases diagnosed as astroblastoma (two low grades; six anaplastic) based on histology and proliferative index. The tumours displayed characteristic astroblastic pseudorosettes with hyalinised vascular core and variable immunopositivity for glial fibrillary acidic protein, pan cytokeratin, and epithelial membrane antigen. MN1 break-apart by FISH was found in 5/8 of our cases (62.5%), which included 2 low-grade and 3 anaplastic tumours. Tumour recurrence was noted in three cases, with MN1 alteration in two. We account for one of the few series to study the MN1 rearrangement in astroblastoma and conclude that MN1 alteration is seen in a subset of these tumours.
Topics: Adolescent; Brain Neoplasms; Child; Diagnosis, Differential; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Neoplasm Recurrence, Local; Neoplasms, Neuroepithelial; Trans-Activators; Tumor Suppressor Proteins; Young Adult
PubMed: 31111274
DOI: 10.1007/s10014-019-00346-x -
Journal of Cancer Research and... 2015Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the... (Review)
Review
Astroblastoma is a rare neuroepithelial primary brain tumor of uncertain origin. They form 0.45-2.8% of all the neuroglial tumors. This tumor is usually localized in the cerebral hemisphere of young adults and children. The authors report a case of low-grade astroblastoma in a 16-year-old male and review the relevant literature. The patient presented with 2 months history of progressive headache with projectile vomiting for last 2 months. He underwent gross total resection of the lesion through right temporo-occipital craniotomy. Since tumor showed no evidence of high-grade lesion, adjuvant radiotherapy was not planned. However, the patient developed recurrence of the tumor after 12 months. Localized three-dimensional conformal radiotherapy was planned. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. They can be easily misdiagnosed as they are rarely encountered in clinical practice and share common radiological and histopathologic appearance with other glial neoplasms.
Topics: Adolescent; Brain Neoplasms; Humans; Male; Neoplasm Recurrence, Local; Neoplasms, Neuroepithelial; Occipital Lobe; Radiography; Treatment Outcome
PubMed: 26458709
DOI: 10.4103/0973-1482.140800