Cerebral astroblastoma: analysis of six cases and critical review of treatment options

Salvati, Maurizio; D’Elia, Alessandro; Brogna, Christian; Frati, Alessandro; Antonelli, Manila; Giangaspero, Felice; Raco, Antonino; Santoro, Antonio; Delfini, Roberto

doi:10.1007/s11060-008-9789-9

Cited by 60 publications

(70 citation statements)

References 22 publications

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“…[2][3][4]10,11 A few low-grade ABs have been reported to be clinically aggressive, however, and some high-grade AB patients have experienced prolonged survival with aggressive surgical and/or adjuvant therapy. 4,6,[11][12][13][14] Because of this variable clinical behavior, ABs have yet to be assigned World Health Organization (WHO) tumor grades, 3 and histological parameters distinguishing clinically benign ABs from aggressive examples are not well defined. Furthermore, there appears to be a relatively high degree of discordance among neuropathologists in making the diagnosis of AB.…”

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confidence: 99%

Morphological and molecular features of astroblastoma, includingBRAFV600Emutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults

et al. 2016

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Background. Astroblastomas (ABs) are rare glial tumors showing overlapping features with astrocytomas, ependymomas, and sometimes other glial neoplasms, and may be challenging to diagnose. Methods. We examined clinical, histopathological, and molecular features in 28 archival formalin-fixed, paraffinembedded AB cases and performed survival analyses using Cox proportional hazards and Kaplan-Meier methods. Results. Unlike ependymomas and angiocentric gliomas, ABs demonstrate abundant distinctive astroblastic pseudorosettes and are usually Olig2 immunopositive. They also frequently exhibit rhabdoid cells, multinucleated cells, and eosinophilic granular material. They retain immunoreactivity to alpha thalassemia/mental retardation syndrome X-linked, are immunonegative to isocitrate dehydrogenase-1 R132H mutation, and only occasionally show MGMT promoter hypermethylation differentiating them from many diffuse gliomas. Like pleomorphic xanthoastrocytoma, ganglioglioma, supratentorial pilocytic astrocytoma, and other predominantly cortical-based glial tumors, ABs often harbor the BRAF V600E mutation, present in 38% of cases tested (n = 21), further distinguishing those tumors from ependymomas and angiocentric gliomas. Factors correlating with longer patient survival included age less than 30 years, female gender, absent BRAF V600E , and mitotic index less than 5 mitoses/10 highpower fields; however, only the latter was significant by Cox and Kaplan-Meier analyses (n = 24; P = .024 and .012, respectively). This mitotic cutoff is therefore currently the best criterion to stratify tumors into low-grade ABs and higher-grade anaplastic ABs.

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Morphological and molecular features of astroblastoma, includingBRAFV600Emutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults

et al. 2016

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“…The treatment advocated for astroblastoma's include radical surgical resection and in cases where complete excision is not possible, chemotherapy followed by radiotherapy is advocated [6]. Cases of high grade astroblastomas are supposed respond better to radiotherapy when compared to low grade tumors.…”

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confidence: 99%

Cerebral Astroblastoma

Devi¹,

Devi²,

Bora³

et al. 2015

JCR

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Abstract:Background: Astroblastomas are rare glial tumors occuring in the supratentorial region of the brain. They constitute of 0.45%-2.8% of primary glial tumors. Case Report: A 21 year old male patient presented with tumor in the left frontal region which was totally excised. Microscopic examination showed features of low grade astroblastoma. Conclusion: Astroblastomas are rare glial tumors which need to be differentiated from ependymoma, papillary meningioma and glioblastoma with focal astroblastic pattern and IHC helps in diagnosis. The treatment advocated for low grade tumors is radical surgical excision.

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“…A total removal, in view of the well demarcated nature, and radiotherapy seems to be the advisable treatment (12,13,34). It appears that most neurosurgeons would attempt tumor clearance and administer postoperative radiotherapy (5,10,30,34).…”

Section: █ Case Reportmentioning

confidence: 99%

“…It appears that most neurosurgeons would attempt tumor clearance and administer postoperative radiotherapy (5,10,30,34). In the series by Bonnin and Rubinstein (5), complete surgical excision was achieved in 12 of 23 patients.…”

Section: █ Case Reportmentioning

confidence: 99%

“…Gross total resection may result in long-term survival. An anaplastic histology has been associated with recurrence and progression, suggesting that more aggressive treatment, including radiotherapy, is necessary for high-grade lesions (5,7,21,25,29,34,38). Combination chemotherapy has had encouraging success regarding the prognosis (30).…”

Section: █ Case Reportmentioning

confidence: 99%

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Astroblastoma; case report and review of literature

Barakat

Ammar²,

Salama³

et al. 2014

Turkish Neurosurgery

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ABSTRACTa gradual progressive course for the last two weeks. He presented with recurrent attacks of vomiting and confusion that rapidly worsened. Neurologically, the patient was confused and uncooperative with recurrent attacks of vomiting and bradycardia but no other neurological symptoms or signs. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a well-demarcated enhancing spaceoccupying lesion, that was partially cystic, partially calcified in the subependymal area of the left frontal lobe partially projecting into the frontal horn of the lateral ventricle and causing obstructive hydrocephalus (Figure 1). We managed the patient as an urgent case in our intensive care unit (ICU) and performed urgent external ventricular drainage to manage the increased intracranial pressure (ICP). About one week later, we performed surgery for tumor resection by left frontal craniotomy. The tumor was pink-yellow in color, highly vascular, soft in consistency in parts and firm and calcified in other parts and was partially succable and well circumscribed which allowed total resection of the tumor. After the surgery, the patient ws transported routinely to the ICU for 3 days. Follow-up CT showed gross total resection (GTR) with mild postoperative brain edema at the site of surgery. The patient was followed up periodically every month for the first 3 months and then every 6 months without postoperative chemotherapy or radiotherapy and without recurrence. After one year, he showed a recurrent mass at the same site as the primary lesion in the follow-up MRI that was managed █ INTRODUCTION A stroblastoma is a rare glial tumor of the brain. It is estimated to account for 0.45-2.8% of all primary cerebral gliomas (1,30,31). Astroblastomas are initially described by Bailey and Cushing (3) and further characterized by Bailey and Bucy (2). However, much confusion has arisen regarding criteria for their diagnosis in the following years. Moreover, the origin of these tumors has been debated, because they share common histological characteristics with ependymomas and astrocytomas. Recent studies suggested that astroblastoma is a distinct histological and genetic entity (6,7,31,39). It has a distinctive characteristic of perivascular pseudorosettes with frequent vascular hyalinization. Perivascular pseudorosettes in astroblastoma have short and thick cytoplasmic processes and blunt-ended foot plates (30).We introduced a case of astroblastoma and reviewed all relevant literature of astroblastoma in order to discuss astroblastoma from the clinical, pathological, management, and prognostic view points. We tried to discover more secrets of astroblastoma and to introduce a standard approach to its diagnosis and management. █ CASE REPORTA forty-year old male patient complained of headache, nausea, vomiting, and deterioration of conscious level with Astroblastoma is a rare and distinct type of aggressive glial tumor for which there is much confusion regarding the diagnostic criteria. We present a case of astroblastoma and review...

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Cerebral astroblastoma: analysis of six cases and critical review of treatment options

Cited by 60 publications

References 22 publications

Morphological and molecular features of astroblastoma, includingBRAFV600Emutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults

Morphological and molecular features of astroblastoma, includingBRAFV600Emutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults

Cerebral Astroblastoma

Astroblastoma; case report and review of literature

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