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Anaplastic Astroblastoma Presenting as Massive, Sudden-Onset, Intraparenchymal Hemorrhage.
MedLine Citation:
PMID:  21540623     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Astroblastoma is a rare primary glial tumor of children and young adults, typically located in the cerebral hemispheres and presenting as a well-circumscribed, nodular, often cystic enhancing mass. The existence of astroblastoma as a distinct clinicopathologic entity has long been debated but is recognized in the 2007 WHO classification of CNS tumors. The grading of these tumors remains unsettled. Currently, no grade has been established and there are no clearly defined diagnostic criteria for low- or high-grade tumors. Astroblastomas in general are thought to have a favorable outcome with low rates of recurrence following gross total resection. We report a case of astroblastoma with 'high-grade/anaplastic' histology in a 12-year-old, previously healthy girl. The patient experienced severe, sudden-onset headache, and quickly became comatose. Head CT showed a massive intraparenchymal hemorrhage in the right frontal lobe with surrounding edema. She underwent emergent posterior frontal craniotomy for decompression and hematoma evacuation. Pathologic examination revealed a sharply demarcated hemorrhagic heterogeneous glial tumor with focal papillary architecture, densely hyalinized blood vessels, and intensely GFAP-positive perivascular cells. The tumor showed unequivocal high-grade features including an elevated proliferative index. The diagnosis of anaplastic astroblastoma was rendered. The patient expired on postoperative day 30. This case illustrates the potential poor outcome of high-grade astroblastoma and highlights the morphologic heterogeneity of this rare neoplasm.
Authors:
Karen A Johnson; Jose M Bonnin; Joel C Boaz; Annette C Douglas-Akinwande; Eyas M Hattab
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-03
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  46     ISSN:  1423-0305     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  457-461     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Departments of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Ind., USA.
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