Journal of Pediatric Neurology 2011; 09(02): 265-269
DOI: 10.3233/JPN-2011-0468
Georg Thieme Verlag KG Stuttgart – New York

Low-grade medullary astrocytoma presenting with supratentorial malignant glioma. Is it dissemination and malignant transformation?

Raj Kumar
a   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
,
Priyanka Kawal
a   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
,
Anant Mehrotra
a   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
,
Ashok K. Mahapatra
a   Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

14 December 2009

10 April 2010

Publication Date:
30 July 2015 (online)

Abstract

Astrocytomas are the most common pediatric brain tumors and account for 40.9% of cerebral and 7.7% of all childhood cancers. Here we present a 16 yr male child who was diagnosed and operated for astrocytoma (grade II) of medulla oblongata; he received radiotherapy for residual tumor postoperatively. The patient developed large anaplastic astrocytoma (grade III) in splenium of corpus callosum and bilateral parieto-occipital region after 3 yr of first operation. It seems this tumor disseminated from brainstem, though primary site remained silent because of the effect of postoperative radiation therapy. It might have disseminated through ventricular cerebrospinal fluid pathways. Little is known about low-grade astrocytoma with dissemination and their malignant transformation to high-grade glioma. The optimum therapy or combinations of therapies for such tumors remains unclear. Few aspects of dissemination and malignant transformation of low-grade astrocytoma to high-grade or appearance of fresh tumor etc are discussed in this report.