Diffuse infiltrating astrocytoma of the cervicomedullary region: clinicopathologic entity

Pediatric Neurosurgery
L A SquiresF Epstein

Abstract

Recent imaging and neurosurgical techniques have led to an improvement in the surgical management of children with brainstem tumors (BSTs). Many children with tumors previously considered 'inoperable' can now benefit from surgery. Increased experience has brought about new theories concerning the growth pattern, natural history, classification and optimal management of these tumors. Cervicomedullary (CM) tumors commonly have an indolent presentation reflecting either medullary or cervical spinal cord dysfunction and tend to arise in the upper cervical cord growing into the medulla in a posterior exophytic fashion. Intrinsic BSTs often present acutely with cranial nerve dysfunction and generally arise in the pons with a diffuse infiltrating growth pattern. A 21-month-old patient had developed feeding difficulty and reactive airway disease at approximately 8 months of age. MRI showed a diffuse, nonenhancing tumor in the CM region. Following radical resection, and an unremarkable perioperative course, he aspirated, developed pulmonary insufficiency and expired. Postmortem examination revealed a low-grade diffuse fibrillary astrocytoma extending from C6 to the medulla. The medullary portion arose in a paramedian location and infilt...Continue Reading

Citations

Jul 29, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Salvatore Di MaioPaul Steinbok
Oct 18, 2000·International Journal of Pediatric Otorhinolaryngology·W HabermannG Friedrich
Jun 27, 2015·Journal of Neurosurgery. Pediatrics·Joseph H McAbeePaul Klimo
Feb 5, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Leonardo TariciottiAntonio Santoro

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