Management of intramedullary cystic pilocytic astrocytoma with rhenium-186 intracavitary irradiation: case report.
OBJECTIVE
We report a case of cystic spinal cord pilocytic astrocytoma treated with surgical resection and 2 intracavitary injections of rhenium.


METHODS
A 22-year-old man presented with low-back pain, saddle dysesthesia, and sphincter and sexual dysfunction. Spinal cord magnetic resonance showed a large, cystic, intramedullary tumor extending from T9 to T12.


METHODS
Two surgical approaches and 1 computed tomography (CT)-scan guided tapping allowed shrinkage of the cystic component but each time the cyst enlarged and neurological symptoms worsened. Pathological examination allowed the diagnosis of pilocytic astrocytoma. The patient underwent 2 intracystic CT-scan guided injections of rhenium that achieved good control of cystic component.


CONCLUSIONS
Interstitial intracavitary rhenium brachytherapy of recurrent spinal cord cystic astrocytomas achieved excellent stabilization of the cyst with minor side-effects and dramatic improvement of neurological deficits.
Colnat-Coulbois
Sophie
S
Department of Neurosurgery, University Hospital of Nancy, Nancy, France. sophie.colnat@wanadoo.fr
Klein
Olivier
O
Braun
Marc
M
Thouvenot
Pierre
P
Marchal
Jean-Claude
JC
D001254:Astrocytoma / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery; D001918:Brachytherapy / Q000379:methods*; D002420:Cauda Equina / Q000473:pathology; D003131:Combined Modality Therapy; D003560:Cysts / Q000473:pathology; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery; D019635:Neurosurgical Procedures; D011868:Radioisotopes / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*; D013120:Spinal Cord Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery; D055815:Young Adult
D011868:Radioisotopes; D012211:Rhenium