Pilocytic Astrocytoma in Conus Medullaris in an Adult: A Case Report
Abstract
Pilocytic astrocytoma is a rare glioma, seen predominantly in pediatric population and young adults, within first two decades of life. This is often located in deep midline structures such as brainstem and cerebellum. In adults, this tumor occurs in supratentorial location. It is a rare tumor and is frequently misdiagnosed and mistreated. However, being a low-grade tumor with excellent prognosis, if diagnosed correctly, it can be successfully treated by surgery only. We report a case of 45-year-old male adult patient with conus medullaris tumor who complained of numbness and pain in the limbs and incontinence of urine and bowel. The radiology showed a sharp conus medullaris mass, which was provisionally diagnosed as low-grade glioma and was surgically resected. On intraoperative imprint cytology, it was reported as a low-grade glial tumor. Histopathological examination confirmed the diagnosis of Pilocytic astrocytoma. The patient in under follow up and doing fine.References
Tibbetts KM, Emnett RJ, Gao F, Perry A, Gutmann DH, Leonard JR. Histopathologic predictors of pilocytic astrocytoma event-free survival. Acta Neuropathol. 2009;117:657–665.
Brown PD, Anderson SK, Carrero XW, O'Neill BP, Giannini C, Galanis E, Shah SA, Abrams RA, Curran WJ Jr, Buckner JC, Shaw EG. Adult patients with supratentorial pilocytic astrocytoma: long term follow-up of prospective multicenter clinical trial NCCTG-867251 (Alliance). Neurooncol Pract. 2015 Dec;2(4):199-204.
Cyrine S, Sonia Z, Mounir T, Badderedine S, Kalthoum T, Hedi K, Moncef M. Pilocytic astrocytoma: A retrospective study of 32 cases: Clin Neurol Neurosurg. 2012;115:1220–1225.
V Peter Collins, David T W Jones, Caterina Giannini, Pilocytic astrocytoma: pathology, molecular mechanisms and markers; Acta Neuropathology 2015: 129(6): 775-788.
Malheiros S, Diffuse low-grade astrocytomas malignancy, Neurosci Mag 1998; 2:75-80.
Aarsen FK, Paquier PF, Arts WF, Van Veelen ML, Michiels E, Lequin M et al. Cognitive deficits and predictors 3 years after diagnosis of a pilocytic astrocytoma in childhood. J Clin Oncol. 2009;27(21):3526–32.
Beebe DW, Ris MD, Armstrong FD, Fontanesi J, Mulhern R, Holmes E et al. Cognitive and adaptive outcome in low-grade paediatric cerebellar astrocytomas: evidence of diminished cognitive and adaptive functioning in National Collaborative Research Studies. J Clin Oncol. 2005;23(22):5198–204.
Hayostek CJ, Shaw EG, Scheithauer B, O’Fallon JR, Weiland TL, Schomberg PJ, Kelly PJ, Hu TC.Astrocytomas of the cerebellum. A Comparative Clinicopathologic Study of Pilocytic and Diffuse Astrocytomas. Cancer. 1993;72(3):856–69.
CBTRUS(Central Brain Tumor Registry of the United States ) statistical Report: Primary Brain and Central Nervous System Tumors diagnosed in the US in 2004-2008: Central Brain Tumor Registry of the US, 2012:
Kumar A, Shah RM, Gupta N. Rare tumor of conus medullaris in an adult with a favorable outcome. Journal of Surgical Technique and Case Report. 2012 Jan;4(1):67-68.
Lavrador JP, Oliveira E, Pimentel J, Livraghi S. Adult pilocytic astrocytoma of conus medullaris: clinical considerations and review of the literature. CNS Oncol. 2017 Apr;6(2):107-110.
Burkhard C, Di Patre PL, Schüler D, Schüler G, Yaşargil MG, Yonekawa Y, Lütolf UM, Kleihues P, Ohgaki H. A population-based study of the incidence and survival rates in patients with pilocytic astrocytoma. J Neurosurg. 2003;98:1170–1174.
Nair AP, Mehrotra A, Das KK, Srivastava AK, Sahu RN, Kumar R. Clinico-radiological profile and nuances in the management of cervicomedullary junction intramedullary tumors. Asian J Neurosurg. 2014;9:21–28.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
