title: A polycystic variant of a primary intracranial leptomeningeal astrocytoma: case report and literature review.
abstract: BACKGROUND
  Primary leptomeningeal astrocytomas are rare intracranial tumors. These tumors are believed to originate from cellular nests which migrate by means of aberration, ultimately settling in the leptomeningeal structure. They may occur in both solitary and diffuse forms. The literature reports only fifteen cases of solitary primary intracranial leptomeningeal astrocytomas.
  
  
  METHODS
  The authors report the case of a seventy-eight year-old woman with a polycystic variant of a solitary primary intracranial leptomeningeal astrocytoma. The first neurological signs were seizures and aphasia. CT and MRI scans demonstrated a fronto-parietal polycystic tumor adherent to the sub arachnoid space. A left fronto-temporo-parietal craniotomy revealed a tight coalescence between the tumor and the arachnoid layer which appeared to wrap the mass entirely. Removal of the deeper solid part of the tumor resulted difficult due to the presence of both a high vascularity and a tight adherence between the tumor and the ventricular wall.
  
  
  CONCLUSIONS
  A new case of a solitary primitive intracranial leptomeningeal astrocytoma of a rare polycystic variant is reported. Clinical, surgical, pathologic and therapeutic aspects of this tumor are discussed.
authors.affiliation: Department of Neurology and Neuropsychiatry Sciences, University of Bari, 70124 Bari, Italy. adetommasi@neurosurgery.uniba.it
authors.forename: Antonio
authors.initials: A
authors.lastname: De Tommasi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Occhiogrosso
authors.forename: Claudio
authors.initials: C
authors.lastname: De Tommasi
authors.forename: Sabino
authors.initials: S
authors.lastname: Luzzi
authors.forename: Antonella
authors.initials: A
authors.lastname: Cimmino
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Ciappetta
mesh_terms: D000368:Aged; D001099:Arachnoid / Q000473:pathology*; D001254:Astrocytoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D001707:Biopsy, Needle; D002555:Cerebrospinal Fluid / Q000166:cytology; D003399:Craniotomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D019635:Neurosurgical Procedures / Q000379:methods; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome