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.
Department of Neurology, Atrium Medisch Centrum Parkstad, PO Box 4446, 6401 CX, Heerlen, The Netherlands. TSR01@atriummc.nl
Tobien
T
Schreuder
Merijn
M
Te Lintelo
Bela
B
Kubat
Peter
P
Koehler
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