Clinical features and therapeutic effect of spinal pilocytic astrocytoma_West China Medical Journal

Authors：

KONG Desheng ¹ , XIA Qing ¹ , LI Kai ¹ , YE Xun ^1,2 ,  JIA Wenqing ² , WANG Rong ^1,2 , ZHAO Yuanli ^1,2

1. Department of Neurosurgery, Peking University International Hospital, Beijing 102206, P. R. China;
2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P. R. China;

Corresponding author：

JIA Wenqing, Email: coffeemd@163.com

Keywords：

Spinal pilocytic astrocytoma; Clinical features; Treatment; Prognosis

DOI：

10.7507/1002-0179.201805038

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo explore the clinical features, diagnosis, treatment, and prognosis of spinal pilocytic astrocytoma.MethodsFrom January 2011 to December 2017, a total of 12 cases of spinal pilocytic astrocytoma were enrolled in Department of Neurosurgery of Beijing Tiantan Hospital Affiliated to the Capital Medical University and Peking University International Hospital. They all received microscopic surgery and the pathologic diagnosis were spinal cord pilocytic astrocytoma; the clinical and radiographic features, treatment and prognosis were retrospectively analyzed.ResultsThere were 9 males and 3 females in this group, with an average age of 25.5 years. Clinical manifestations were related to tumor occupying effect. All the tumors were intramedullary tumors, in which 5 cases located in the cervical spinal cord, and 7 in the thoracic segments. Preoperative medical history recording, physical examination and imaging examination misdiagnosed the tumor as spinal cord ependymoma in 10 cases, enterogenous cyst in 1 case, and high-grade glioma in 1 case. All patients were treated with microsurgical excision: 8 were resected totally, 3 were subtotally, and 1 was partially. None of the patients died after surgery, and the mean follow-up time was 43.1 months. The symptoms of 9 patients were significantly improved, 2 showed no significant change, and 1 had worse symptoms after surgery. No reoperation occured. Two patients underwent routine radiotherapy, and no chemotherapy was performed.ConclusionsSpinal pilocytic astrocytoma tends to occur in adolescent patients with cervical and thoracic spinal cord as the predilection site; the diagnosis is mainly on the basis of tumor tissue typical two-way structure, Rosenthal fiber, and eosinophilic granular corpuscle. Preoperative medical history, physical examination and imaging examination are easily misdiagnosed as spinal cord ependymoma. Prognosis of surgical treatment is very good.

Citation： KONG Desheng, XIA Qing, LI Kai, YE Xun, JIA Wenqing, WANG Rong, ZHAO Yuanli. Clinical features and therapeutic effect of spinal pilocytic astrocytoma. West China Medical Journal, 2018, 33(6): 709-713. doi: 10.7507/1002-0179.201805038 Copy

1.	Horger M, Ritz R, Beschorner R, et al. Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol, 2011, 79(3): 389-399.
2.	Harraher CD, Vogel H, Steinberg GK. Spinal pilocytic astrocytoma in an elderly patient. World Neurosurg, 2013, 79(5/6): e7-e9.
3.	Nakano Y, Yamamoto J, Takahashi M, et al. Pilocytic astrocytoma presenting with atypical features on magnetic resonance imaging. J Neuroradiol, 2015, 42(5): 278-282.
4.	Li WQ, Wang X, Zhong NZ, et al. Spinal hemangioblastoma combined with pilocytic astrocytoma. Neurosciences (Riyadh), 2015, 20(3): 280-284.
5.	Tobin MK, Geraghty JR, Engelhard HH, et al. Intramedullary spinal cord tumors: a review of current and future treatment strategies. Neurosurg Focus, 2015, 39(2): E14.
6.	Ebner FH, Schittenhelm J, Roser FA, et al. Management of holocord pilocytic astrocytomas in children and adolescents: an update. Pediatr Neurosurg, 2012, 48(3): 133-140.
7.	Basheer A, Rammo R, Kalkanis S, et al. Multifocal intradural extramedullary pilocytic astrocytomas of the spinal cord: a case report and review of the literature. Neurosurgery, 2017, 80(2): E178-E184.
8.	Lavrador J P, Oliveira E, Pimentel J, et al. Adult pilocytic astrocytoma of conus medullaris: clinical considerations and review of the literature. CNS Oncol, 2017, 6(2): 107-110.
9.	Lourenco EP, Nzwalo H, Sampaio MR, et al. Pilocytic astrocytoma. BMJ Case Rep, 2016, 2016: pii: bcr2015213013.
10.	Bornhorst M, Frappaz D, Packer RJ. Pilocytic astrocytomas. Handb Clin Neurol, 2016, 134: 329-344.
11.	Theeler BJ, Ellezam B, Sadighi ZS, et al. Adult pilocytic astrocytomas: clinical features and molecular analysis. Neuro Oncol, 2014, 16(6): 841-847.
12.	Bond KM, Hughes JD, Porter AL, et al. Adult pilocytic astrocytoma: an institutional series and systematic literature review for extent of resection and recurrence. World Neurosurg, 2018, 110: 276-283.
13.	Jones DT, Hutter B, Jaeger NA, et al. Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma. Nat Genet, 2013, 45(8): 927-932.
14.	Collins VP, Jones DT, Giannini C. Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol, 2015, 129(6): 775-88.
15.	Zadnik PL, Gokaslan ZL, Burger PC, et al. Spinal cord tumours: advances in genetics and their implications for treatment. Nat Rev Neurol, 2013, 9(5): 257-266.
16.	毛怡, 方靖琴. 成人脊髓多发毛细胞性星型细胞瘤一例. 影像诊断与介入放射学, 2017(1): 70-71.

1. Horger M, Ritz R, Beschorner R, et al. Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol, 2011, 79(3): 389-399.
2. Harraher CD, Vogel H, Steinberg GK. Spinal pilocytic astrocytoma in an elderly patient. World Neurosurg, 2013, 79(5/6): e7-e9.
3. Nakano Y, Yamamoto J, Takahashi M, et al. Pilocytic astrocytoma presenting with atypical features on magnetic resonance imaging. J Neuroradiol, 2015, 42(5): 278-282.
4. Li WQ, Wang X, Zhong NZ, et al. Spinal hemangioblastoma combined with pilocytic astrocytoma. Neurosciences (Riyadh), 2015, 20(3): 280-284.
5. Tobin MK, Geraghty JR, Engelhard HH, et al. Intramedullary spinal cord tumors: a review of current and future treatment strategies. Neurosurg Focus, 2015, 39(2): E14.
6. Ebner FH, Schittenhelm J, Roser FA, et al. Management of holocord pilocytic astrocytomas in children and adolescents: an update. Pediatr Neurosurg, 2012, 48(3): 133-140.
7. Basheer A, Rammo R, Kalkanis S, et al. Multifocal intradural extramedullary pilocytic astrocytomas of the spinal cord: a case report and review of the literature. Neurosurgery, 2017, 80(2): E178-E184.
8. Lavrador J P, Oliveira E, Pimentel J, et al. Adult pilocytic astrocytoma of conus medullaris: clinical considerations and review of the literature. CNS Oncol, 2017, 6(2): 107-110.
9. Lourenco EP, Nzwalo H, Sampaio MR, et al. Pilocytic astrocytoma. BMJ Case Rep, 2016, 2016: pii: bcr2015213013.
10. Bornhorst M, Frappaz D, Packer RJ. Pilocytic astrocytomas. Handb Clin Neurol, 2016, 134: 329-344.
11. Theeler BJ, Ellezam B, Sadighi ZS, et al. Adult pilocytic astrocytomas: clinical features and molecular analysis. Neuro Oncol, 2014, 16(6): 841-847.
12. Bond KM, Hughes JD, Porter AL, et al. Adult pilocytic astrocytoma: an institutional series and systematic literature review for extent of resection and recurrence. World Neurosurg, 2018, 110: 276-283.
13. Jones DT, Hutter B, Jaeger NA, et al. Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma. Nat Genet, 2013, 45(8): 927-932.
14. Collins VP, Jones DT, Giannini C. Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol, 2015, 129(6): 775-88.
15. Zadnik PL, Gokaslan ZL, Burger PC, et al. Spinal cord tumours: advances in genetics and their implications for treatment. Nat Rev Neurol, 2013, 9(5): 257-266.
16. 毛怡, 方靖琴. 成人脊髓多发毛细胞性星型细胞瘤一例. 影像诊断与介入放射学, 2017(1): 70-71.

Previous Article
Therapeutic effect of bromocriptine on prolactinoma with different types
Next Article
Unilateral frontal approaches for the removal of large bilateral olfactory groove meninjiomas

West China Medical Journal

Clinical features and therapeutic effect of spinal pilocytic astrocytoma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content