Multifocal Pilocytic Astrocytomas With Ependymal Differentiation in the Bilateral Medial Temporal Lobes
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概要
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A 7-year-old boy presented with headache, visual disturbance, and psychomotor seizures persisting for 7 months. He had mild hemiparesis and homonymous hemianopia on the left. Neuroimaging showed bilateral temporal lobe masses with calcification and cysts. The right temporal mass was subtotally resected. The histological diagnosis was pilocytic astrocytoma with ependymal differentiation and a MIB-1 staining index of up to 8.0%. Postoperatively his hemiparesis and psychomotor seizures disappeared. Adjuvant chemotherapy consisting of carboplatin and vincristine was given followed by radiotherapy. Neuroimaging showed that the bilateral tumors had disappeared and showed no recurrence for 29 months after the diagnosis. Pilocytic astrocytoma usually presents as a solitary mass in the cerebellum or optic pathway with low proliferative activity, but should be included in the differential diagnosis of multifocal tumors arising in the bilateral temporal lobes. Ependymal differentiation with extremely high proliferative activity might be related to this unusual clinical presentation. Intensive treatment is recommended for patients with such specific neuroimaging and histological features.
- 日本脳神経外科学会の論文
- 2005-08-15
著者
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MORITA Akio
Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT East Corporation
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KIRINO Takaaki
Department of Neurosurgery
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MARUYAMA Keisuke
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentist
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NAKAZATO Yoichi
First Department of Pathology, Gunma University School of Medicine
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Kirino Takaaki
Departments Of Neurosurgery The University Of Tokyo Hospital
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SHIBAHARA Junji
Department of Pathology, Graduate School of Medicine, The University of Tokyo
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Maruyama Keisuke
Department Of Medicine And Clinical Science Okayama University Graduate School Of Medicine Dentistry
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Maruyama Keisuke
Departments Of Neurosurgery The University Of Tokyo Hospital
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Nakazato Yoichi
First Department Of Pathology Gunma University School Of Medicine
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Shibahara Junji
Department Of Human Pathology The University Of Tokyo
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Morita Akio
Departments Of Neurosurgery The University Of Tokyo Hospital
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Morita Akio
Department Of Applied Biological Chemistry Shizuoka Uiniversity
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Maruyama Keisuke
Department of Biology, Faculty of Science, Toyama University
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