Malignant transformation of a chiasmatic pilocytic astrocytoma in a patient with diencephalic syndrome.
Chiasmatic gliomas with metastatic spread are rare in children and are usually associated with diencephalic syndrome. They are mostly pilocytic astrocytomas and their transformation to high-grade astrocytomas has never previously been reported in the pediatric population. We report leptomeningeal spread of a chiasmatic pilocytic astrocytoma in a child presenting with diencephalic syndrome. He was treated with chemotherapy and radiation. The tumor recurred with transformation into a high-grade astrocytoma. Radiation therapy may have played a role in transformation of the tumor, but more research is needed to further clarify the biological behavior of this tumor.
van der Wal
Ester J
EJ
Department of Radiology, Indiana University, Division of Neuroradiology, James Whitcomb Riley Children's Hospital, 702 Barnhill Drive, MRI Suite, Indianapolis 46202-5200, USA. medward@IUPUI.edu
Azzarelli
Biagio
B
Edwards-Brown
Mary
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001254:Astrocytoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D001707:Biopsy, Needle; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D004027:Diencephalon / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009897:Optic Chiasm / Q000473:pathology*; D019574:Optic Nerve Neoplasms / Q000473:pathology* / Q000628:therapy; D018570:Risk Assessment; D013577:Syndrome