Anaplastic oligo-astrocytoma occurring after resection of a cerebral cavernous malformation; malignant transformation? Case report and review on etiology.
We report a 71-year-old woman who presented with a cerebral cavernous malformation in the right frontal lobe for which she underwent total resection. Three years later, she was admitted with seizures and neuroimaging revealed a partially calcified lesion in the area of the earlier cavernous malformation, consistent with a residual malformation. A few months later she presented with cognitive decline and neuroimaging now revealed a large mass lesion in the same area as the cavernous malformation, irregularly enhancing, spreading through the corpus callosum to the left frontal lobe. Histological examination showed an anaplastic oligo-astrocytoma. These findings suggest that cerebral cavernous malformations, or at least a subgroup, have the potential for oligodendrocytic and astrocytic transformation. Various hypotheses to explain the etiology of these rare cases are discussed.
Schreuder
Tobien
T
Department of Neurology, Atrium Medisch Centrum Parkstad, PO Box 4446, 6401 CX, Heerlen, The Netherlands. TSR01@atriummc.nl
Te Lintelo
Merijn
M
Kubat
Bela
B
Koehler
Peter
P
D000368:Aged; D001253:Astrocytes / Q000473:pathology; D001254:Astrocytoma / Q000098:blood supply / Q000209:etiology / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000098:blood supply / Q000209:etiology / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D018450:Disease Progression; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness / Q000473:pathology / Q000503:physiopathology; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D019635:Neurosurgical Procedures / Q000009:adverse effects; D009836:Oligodendroglia / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed