Adult anaplastic pilocytic astrocytoma - a diagnostic challenge? A case series and literature review.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_CBCA193AE11F
Type
Article: article from journal or magazin.
Collection
Publications
Title
Adult anaplastic pilocytic astrocytoma - a diagnostic challenge? A case series and literature review.
Journal
Clinical neurology and neurosurgery
Author(s)
Fiechter M., Hewer E., Knecht U., Wiest R., Beck J., Raabe A., Oertel M.F.
ISSN
1872-6968 (Electronic)
ISSN-L
0303-8467
Publication state
Published
Issued date
08/2016
Peer-reviewed
Oui
Volume
147
Pages
98-104
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Review
Publication Status: ppublish
Abstract
Anaplastic pilocytic astrocytoma (APA) is an exceptionally rare type of high-grade glioma in adults. Establishing histopathological diagnosis is challenging and its clinical and radiological appearance insidious. By this case series and first literature review we investigated the various clinical, neuroradiological, and histopathological features of APA in adults.
An in hospital screening of the database from the Institute of Pathology was conducted to identify cases of APA. Further, we performed a literature review in PubMed using the keywords "anaplastic/malignant/atypical AND pilocytic astrocytoma" and "anaplastic astrocytoma/glioblastoma AND Rosenthal fibers" and summarized the current knowledge about APA in adults.
Over the last decade we were able to identify 3 adult patients with APA in our hospital. According to the pertinent literature, the prognosis of APA in adults (documented survival of up to 10 years) appears to be better than in other high-grade gliomas. Few cases were associated with neurofibromatosis type 1, which seems to predispose for development of APA. Although molecular genetics is still of limited value for differentiation of APA from other high-grade glioma, advanced neuroimaging techniques such as magnetic resonance perfusion imaging and spectroscopy allow improved differential work-up. In particular, APA in adults has the ability to mimic various neurological diseases such as tumefactive demyelinating lesions, low-, or high-grade gliomas.
Although currently not explicitly recognized as a distinct clinico-pathologic entity it seems that adult APA behaves differently from conventional high-grade glioma and should be included in differential diagnostics to enable adequate patient care. However, further studies are needed to better understand this extremely rare disease.
Keywords
Adult, Astrocytoma/diagnosis, Brain Neoplasms/diagnosis, Female, Humans, Male, Middle Aged, Anaplastic, Diagnosis, Glioma, Pilocytic astrocytoma, Rare
Pubmed
Web of science
Open Access
Yes
Create date
31/08/2020 13:02
Last modification date
10/11/2020 7:26
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