Purely Intraventricular Desmoplastic Infantile Astrocytoma

Giovanni Federico Nicoletti; Giuseppe Emmanuele Umana; Carmelo Riolo; Gaetano Magro; Giovanni Bartoloni; Gianluca Scalia

doi:10.1055/s-0041-1723755

Journal of Pediatric Neurology, Table of Contents

Journal of Pediatric Neurology 2021; 19(06): 452-456
DOI: 10.1055/s-0041-1723755

Case Report

Purely Intraventricular Desmoplastic Infantile Astrocytoma

Giovanni Federico Nicoletti

¹Neurosurgery Unit, Highly Specialized Hospital of National Importance “Garibaldi,” Catania, Italy

,

Giuseppe Emmanuele Umana

²Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy

,

Carmelo Riolo

¹Neurosurgery Unit, Highly Specialized Hospital of National Importance “Garibaldi,” Catania, Italy

,

Gaetano Magro

³Anatomic Pathology Section, Department of Medical, Surgical Sciences and Advanced Technologies and Biotechnological Sciences, G.F. Ingrassia, University of Catania, Catania, Italy

,

Giovanni Bartoloni

⁴Anatomic Pathology Unit, Highly Specialized Hospital of National Importance “Garibaldi,” Catania, Italy

,

Gianluca Scalia

¹Neurosurgery Unit, Highly Specialized Hospital of National Importance “Garibaldi,” Catania, Italy

› Author Affiliations

Abstract

Desmoplastic infantile astrocytomas (DIAs) are rare pediatric tumors characterized by superficial brain cortex involvement, along with the meninges of the supratentorial compartment, and are classified as grade I neoplasms according to the 2016 World Health Organization. A 5-year-old girl child patient was admitted to our unit with abnormal decorticate posturing, bilateral mydriasis with weak pupillary light reflex, and brisk lower limbs reflexes. Her medical history was unremarkable. Magnetic resonance imaging of the brain revealed a massive lesion with bilateral intraventricular growth mainly prevailing on the left and involving the ipsilateral foramen of Monro. After external ventricular drainage positioning, Dandy's transfrontal transcortical approach to the left lateral ventricle, a meticulous ependymal microsurgical dissection of the lesion was performed, resulting in an excision of the cystic component of the left lateral ventricle. A gross total removal of the lesion was performed with an en bloc resection of the deeper cystic part. Thirty days after surgery, the patient presented with fluent speech, conserved axial, and extremity sensorimotor functions, except a mild central facial paresis which progressively improved. To the best of our knowledge, this is the first case of DIA characterized by purely intraventricular growth. Tumor recurrence, although considered rare, represents an unpredictable event. Therefore, an adequate follow-up must be reserved for each patient.

Keywords

desmoplastic infantile astrocytoma - brain - intraventricular - tumor

Full Text

References

References
1 Taratuto AL, Monges J, Lylyk P, Leiguarda R. Superficial cerebral astrocytoma attached to dura. Report of six cases in infants. Cancer 1984; 54 (11) 2505-2512
2 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016; 131 (06) 803-820
3 Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathol 1993; 3 (03) 255-268
4 Naylor RM, Wohl A, Raghunathan A, Eckel LJ, Keating GF, Daniels DJ. Novel suprasellar location of desmoplastic infantile astrocytoma and ganglioglioma: a single institution's experience. J Neurosurg Pediatr 2018; 22 (04) 397-403
5 Chacko G, Chandi SM, Chandy MJ. Desmoplastic low grade astrocytoma: a case report and review of literature. Clin Neurol Neurosurg 1995; 97 (01) 32-35
6 Kurose A, Beppu T, Miura Y. et al. Desmoplastic cerebral astrocytoma of infancy intermingling with atypical glial cells. Pathol Int 2000; 50 (09) 744-749
7 Mallucci C, Lellouch-Tubiana A, Salazar C. et al. The management of desmoplastic neuroepithelial tumours in childhood. Childs Nerv Syst 2000; 16 (01) 8-14
8 Kato M, Yano H, Okumura A, Shinoda J, Sakai N, Shimokawa K. A non-infantile case of desmoplastic infantile astrocytoma. Childs Nerv Syst 2004; 20 (07) 499-501
9 Kopniczky Z, Kóbor J, Maráz A, Vajtai I. Desmoplastic neuroepithelial tumor of infancy in the nevus sebaceus syndrome: report of a unique constellation and review of the literature. Pathol Res Pract 2001; 197 (04) 279-284
10 Trehan G, Bruge H, Vinchon M. et al. MR imaging in the diagnosis of desmoplastic infantile tumor: retrospective study of six cases. AJNR Am J Neuroradiol 2004; 25 (06) 1028-1033
11 Ulu MO, Tanriöver N, Biçeroğlu H, Oz B, Canbaz B. A case report: a noninfantile desmoplastic astrocytoma. Turk Neurosurg 2008; 18: 42-46
12 Uro-Coste E, Ssi-Yan-Kai G, Guilbeau-Frugier C. et al. Desmoplastic infantile astrocytoma with benign histological phenotype and multiple intracranial localizations at presentation. J Neurooncol 2010; 98 (01) 143-149
13 Rasalkar DD, Paunipagar BK, Ng A. Primary spinal cord desmoplastic astrocytoma in an adolescent: a rare tumour at rare site and rare age. Hong Kong Med J 2012; 18 (03) 253-255
14 Darwish B, Arbuckle S, Kellie S, Besser M, Chaseling R. Desmoplastic infantile ganglioglioma/astrocytoma with cerebrospinal metastasis. J Clin Neurosci 2007; 14 (05) 498-501
15 Rojas-Medina LM, Carrasco-Moro R, Rivero-Garvía M, Esteban-Fernández L, Rivas-Infante E, Márquez-Rivas J. Desmoplastic astrocytoma: new insights into its clinical profile, diagnosis, and treatment. Childs Nerv Syst 2016; 32 (09) 1577-1585
16 Vajtai I. Desmoplastic cerebral astrocytoma in intraventricular location: simplifying histogenesis by broadening the spectrum of desmoplastic neuroepithelial tumors of infancy?. AJR Am J Roentgenol 1997; 168 (05) 1385-1385
17 Al-Kharazi K, Gillis C, Steinbok P, Dunham C. Malignant desmoplastic infantile astrocytoma? A case report and review of the literature. Clin Neuropathol 2013; 32 (02) 100-106
18 Sugiyama K, Arita K, Shima T. et al. Good clinical course in infants with desmoplastic cerebral neuroepithelial tumor treated by surgery alone. J Neurooncol 2002; 59 (01) 63-69
19 Gu S, Bao N, Yin MZ. Combined fontanelle puncture and surgical operation in treatment of desmoplastic infantile astrocytoma: case report and a review of the literature. J Child Neurol 2010; 25 (02) 216-221
20 Tsuji K, Nakasu S, Tsuji A, Fukami T, Nozaki K. [Postoperative regression of desmoplastic infantile astrocytoma]. No Shinkei Geka 2008; 36 (11) 1035-1039
21 Kandalkar B, Shah V, Shet T. Desmoplastic astrocytoma of infancy–a case report. Indian J Pathol Microbiol 2001; 44 (03) 329-332
22 Aydin F, Ghatak NR, Salvant J, Muizelaar P. Desmoplastic cerebral astrocytoma of infancy. A case report with immunohistochemical, ultrastructural and proliferation studies. Acta Neuropathol 1993; 86 (06) 666-670
23 Beppu T, Sato Y, Uesugi N, Kuzu Y, Ogasawara K, Ogawa A. Desmoplastic infantile astrocytoma and characteristics of the accompanying cyst. Case report. J Neurosurg Pediatr 2008; 1 (02) 148-151
24 Abuharbid G, Esmaeilzadeh M, Hartmann C, Hermann EJ, Krauss JK. Desmoplastic infantile astrocytoma with multiple intracranial and intraspinal localizations at presentation. Childs Nerv Syst 2015; 31 (06) 959-964
25 Karabagli P, Karabagli H, Kose D, Kocak N, Etus V, Koksal Y. Desmoplastic non-infantile astrocytic tumor with BRAF V600E mutation. Brain Tumor Pathol 2014; 31 (04) 282-288
26 Park K, Yoo J, Cho H, Cho W, Park S. Desmoplastic cerebral astrocytoma of infancy: a case report. J Korean Med Sci 1998; 13 (04) 440-444
27 Phi JH, Koh EJ, Kim SK, Park SH, Cho BK, Wang KC. Desmoplastic infantile astrocytoma: recurrence with malignant transformation into glioblastoma: a case report. Childs Nerv Syst 2011; 27 (12) 2177-2181
28 Bock D, Rümmele P, Friedrich M, Wolff JE. Multifocal desmoplastic astrocytoma, frontal lobe dysplasia, and simian crease. J Pediatr 2002; 141 (03) 445
29 Rojas-Medina LM, Carrasco Moro R. Multiple desmoplastic astrocytoma: a benign neoplasm?. Childs Nerv Syst 2015; 31 (11) 2007-2008
30 Setty SN, Miller DC, Camras L, Charbel F, Schmidt ML. Desmoplastic infantile astrocytoma with metastases at presentation. Mod Pathol 1997; 10 (09) 945-951
31 Santhosh K, Kesavadas C, Radhakrishnan VV, Abraham M, Gupta AK. Multifocal desmoplastic noninfantile astrocytoma. J Neuroradiol 2008; 35 (05) 286-291