A polycystic variant of a primary intracranial leptomeningeal astrocytoma: case report and literature review.
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.
De Tommasi
Antonio
A
Department of Neurology and Neuropsychiatry Sciences, University of Bari, 70124 Bari, Italy. adetommasi@neurosurgery.uniba.it
Occhiogrosso
Giuseppe
G
De Tommasi
Claudio
C
Luzzi
Sabino
S
Cimmino
Antonella
A
Ciappetta
Pasqualino
P
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