Presentation
We present the case of a 54-year-old patient with a history of seizures since the age of six years old, who presented on admission with progressive worsening and unresponsiveness to treatment, starting six months prior to presentation. [ncbi.nlm.nih.gov]
Immunohistological and ultrastructural features of this tumor are presented. The discussion focuses on the biology, natural history, and management of this unusual neoplasm. [dx.doi.org]
Entire Body System
- Fatigue
Symptoms of hypopituitarism are fatigue, weakness, loss of libido, and hypothyroidism. [braincancer.org]
Eyes
- Visual Impairment
Symptoms include headache, paresthesias, seizures, personality changes, confusion and visual impairment. Surgery can cure meningioma, if the entire tumor is removed. [braincancer.org]
Psychiatrical
- Suggestibility
Hemorrhage, which suggested the presence of a vascular lesion in this patient, has not been previously described as a feature of this neoplasm. [ncbi.nlm.nih.gov]
Microscopic findings suggest a closer resemblance of tumor cells to astroblasts rather than to "tanycytes" or ependymal cells. [scholars.northwestern.edu]
- Aggressive Behavior
behavior"@eng Bibliographic information Publisher: Berlin/Heidelberg : Springer-Verlag All titles: "Anaplastic astroblastoma of childhood: aggressive behavior"@eng [agris.fao.org]
@article{Kantar2009AnaplasticAO, title={Anaplastic astroblastoma of childhood: aggressive behavior}, author={Mehmet Kantar and Yeşim Ertan and Tuncer Turhan and Omer Kitis and Yavuz Anacak and Taner Akalın and Yusuf Erşahin and Nazan Çeting{\"u}l}, journal [semanticscholar.org]
Cytologic pleomorphism and a high mitotic count are usually associated with rapid growth and aggressive behavior. [clinicalgate.com]
Kantar M, Ertan Y, Turhan T, et al: Anaplastic astroblastoma of childhood: aggressive behavior. Childs Nerv Syst 2009;25:1125–1129. [karger.com]
( 20437876 ) Mastrangelo S....Riccardi R. 2010 44 Anaplastic astroblastoma of childhood: aggressive behavior. ( 19357852 ) Kantar M....CetingA1l N. 2009 45 Cerebral astroblastoma: analysis of six cases and critical review of treatment options. ( 19214707 [malacards.org]
Neurologic
- Lethargy
[8][9][10] In the first few months, morning activities are usually unaffected; over time, these effects become more pronounced, especially late at night.[2][6][7] Lethargy can disrupt vital signs, depleting energy and desire to perform simple cognitive [en.wikipedia.org]
Workup
Full pathologic workup later revealed the patient had two distinct tumors occurring simultaneously, anaplastic astrocytoma and astroblastoma. [ncbi.nlm.nih.gov]
Afterwards, metastatic workup of the patient including x-ray chest and ultrasound abdomen and pelvis did not revealed any spread of the disease. [synapse.koreamed.org]
A metastatic workup with CT of the chest, abdomen, and pelvis however was unremarkable. The patient and his family wanted a biopsy performed first for tissue diagnosis before they would decide on proceeding with a gross resection. [hindawi.com]
Treatment
Surgical resection is the standard initial treatment for astroblastomas. Still, some astroblastomas that have been completely resected recur. The optimal treatment for these lesions is unclear. [ncbi.nlm.nih.gov]
Based on the authors’ limited experience with 7 cases, resection with the goal of GTR is currently the mainstream treatment for AB, and adjuvant radiation treatment should be considered after surgery. [thejns.org]
Prognosis
Prognosis, however, sometimes is in contradiction with the pathological appearance and seems to be more closely related to the grade of surgical resection. [ncbi.nlm.nih.gov]
Low grade astroblastomas seem to have a better prognosis than the high grade ones3. [scielo.isciii.es]
Etiology
Hemorrhagic appearance is not uncommon; there are three reported cases in which radiologic presentation was confused with vascular etiologies because the initial presentation was acute hemorrhage.[ 1 22 31 ] Differential diagnoses in imaging are ependymoma [surgicalneurologyint.com]
Epidemiology
Epidemiology Reliable epidemiological data regarding astroblastoma are not available. These lesions are most common in young adults, but may occur in infants and children. [prod.wiki.cns.org]
Definition / general Rare ( < 3% of primary brain gliomas), compact glial neoplasm with perivascular pseudorosettes formed of GFAP+ cells arranged around central, often sclerotic, blood vessels Controversial entity - relationship with ependymoma is not clear Epidemiology [pathologyoutlines.com]
This is the leading international professional reference text that also serves as a bench book, describing all aspects of the pathology of brain tumours - genetics, molecular biology, epidemiology, morphology, immunohistochemistry, diagnostic criteria [books.google.com]
Pathophysiology
We report two patients with astroblastoma who presented with hemorrhage and discuss the natural history, radiological findings, pathophysiology of hemorrhage and histopathological characteristics. [ncbi.nlm.nih.gov]
It brings together the pathophysiology of disease with detailed clinical guidance on diagnosis and management for the full range of childhood cancers, including aspects important in optimal supportive care. [books.google.com]
Singla et al. report two patients with astroblastoma who presented with hemorrhage and discuss the natural history, radiological findings, pathophysiology of hemorrhage and histopathological characteristics. [operativeneurosurgery.com]
Prevention
Its rarity has prevented evidenced-based treatment stratification. An 8-year-old boy presented with signs and symptoms of raised intracranial pressure. [ncbi.nlm.nih.gov]
Prophylactic anticonvulsants for prevention of immediate and early postcraniotomy seizures. [n.neurology.org]
“It could lead to detection very early in the formation of these types of tumors, new treatments or potentially even strategies to prevent their formation.” [uoflnews.com]