Cranial Pilocytic Astrocytoma With Spinal Drop Metastasis in an Adult: Case Report and Literature Review

Aasheen Munshey, Justin M Moore, Catriona Maclean, Anthony Longano, Tony Goldschlager

Research output: Contribution to journalReview ArticleOtherpeer-review

Abstract

Background Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles, and the overall prognosis is favorable. A PA of the brain with spinal metastasis at presentation has never been reported in an adult. Case Description We report a case of a 47-year-old man presenting with sudden-onset frontal headache associated with nausea and lethargy in addition to a background of a longer history of back pain and headache. Radiologic imaging revealed an acute intraparenchymal hemorrhage in the right parieto-occipital lobes with intraventricular extension within a peripherally enhancing heterogeneous lesion. Magnetic resonance imaging of the spine revealed a sacral intradural tumor. The patient underwent surgical resection of the intracranial mass followed by debulking of the spinal lesion. Histopathologic study revealed that both the cranial and spinal tumors were PA. Conclusions This case illustrates a unique instance of hemorrhage into a cerebral PA with a spinal metastasis. To our knowledge, this is the first such case reported in an adult. We review the literature on the subject.

Original languageEnglish
Pages (from-to)883.e7-883.e12
Number of pages6
JournalWorld Neurosurgery
Volume98
DOIs
Publication statusPublished - 1 Feb 2017

Keywords

  • Adult
  • Low-grade glioma
  • Metastasis
  • Pilocytic astrocytoma

Cite this

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title = "Cranial Pilocytic Astrocytoma With Spinal Drop Metastasis in an Adult: Case Report and Literature Review",
abstract = "Background Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles, and the overall prognosis is favorable. A PA of the brain with spinal metastasis at presentation has never been reported in an adult. Case Description We report a case of a 47-year-old man presenting with sudden-onset frontal headache associated with nausea and lethargy in addition to a background of a longer history of back pain and headache. Radiologic imaging revealed an acute intraparenchymal hemorrhage in the right parieto-occipital lobes with intraventricular extension within a peripherally enhancing heterogeneous lesion. Magnetic resonance imaging of the spine revealed a sacral intradural tumor. The patient underwent surgical resection of the intracranial mass followed by debulking of the spinal lesion. Histopathologic study revealed that both the cranial and spinal tumors were PA. Conclusions This case illustrates a unique instance of hemorrhage into a cerebral PA with a spinal metastasis. To our knowledge, this is the first such case reported in an adult. We review the literature on the subject.",
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Cranial Pilocytic Astrocytoma With Spinal Drop Metastasis in an Adult : Case Report and Literature Review. / Munshey, Aasheen; Moore, Justin M; Maclean, Catriona; Longano, Anthony; Goldschlager, Tony.

In: World Neurosurgery, Vol. 98, 01.02.2017, p. 883.e7-883.e12.

Research output: Contribution to journalReview ArticleOtherpeer-review

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N2 - Background Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles, and the overall prognosis is favorable. A PA of the brain with spinal metastasis at presentation has never been reported in an adult. Case Description We report a case of a 47-year-old man presenting with sudden-onset frontal headache associated with nausea and lethargy in addition to a background of a longer history of back pain and headache. Radiologic imaging revealed an acute intraparenchymal hemorrhage in the right parieto-occipital lobes with intraventricular extension within a peripherally enhancing heterogeneous lesion. Magnetic resonance imaging of the spine revealed a sacral intradural tumor. The patient underwent surgical resection of the intracranial mass followed by debulking of the spinal lesion. Histopathologic study revealed that both the cranial and spinal tumors were PA. Conclusions This case illustrates a unique instance of hemorrhage into a cerebral PA with a spinal metastasis. To our knowledge, this is the first such case reported in an adult. We review the literature on the subject.

AB - Background Pilocytic astrocytoma (PA) is a benign neoplasm that typically occurs in the brain within the pediatric and adolescent age groups and is uncommon in adults. It rarely occurs within the ventricles, and the overall prognosis is favorable. A PA of the brain with spinal metastasis at presentation has never been reported in an adult. Case Description We report a case of a 47-year-old man presenting with sudden-onset frontal headache associated with nausea and lethargy in addition to a background of a longer history of back pain and headache. Radiologic imaging revealed an acute intraparenchymal hemorrhage in the right parieto-occipital lobes with intraventricular extension within a peripherally enhancing heterogeneous lesion. Magnetic resonance imaging of the spine revealed a sacral intradural tumor. The patient underwent surgical resection of the intracranial mass followed by debulking of the spinal lesion. Histopathologic study revealed that both the cranial and spinal tumors were PA. Conclusions This case illustrates a unique instance of hemorrhage into a cerebral PA with a spinal metastasis. To our knowledge, this is the first such case reported in an adult. We review the literature on the subject.

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