Summary
Partial resection of a cystic cerebellar astrocytoma with well-differentiated histomorphology in a 13 year old girl was followed by a course of X-ray therapy. After a period of 27 years symptoms recurred. The patient died 2 days after a second operation, and autopsy showed a large partly cystic cerebellar astrocytoma with distinct morphological evidence of malignancy in some areas.
The role of the X-ray therapy in the formation of peculiar bizarre giant cells in our case is discussed. Radio-induction of malignant tumour evolution after long latency has to be considered, but the possibility seems remote. However, the value of radiotherapy for cystic cerebellar astrocytomas needs some reconsideration. More caution in the long term prognosis of cystic cerebellar astrocytomas of childhood might be appropriate.
Similar content being viewed by others
References
Bernell, W. R., J. J. Kepes, and E. P. Seitz, Late malignant recurrence of childhood cerebellar astrocytoma. Report of two cases. J. Neurosurg.37 (1972), 470–474.
Biemond, A., Cerebellar tumours. In: Handb. Clin. Neurol., Vol. 17, Eds. Vinken, P. J., and G. W. Bruyn, p. 707–718. Amsterdam: North-Holland. 1974.
Bucy, P. C., and P. W. Thieman, Astrocytomas of the cerebellum. A study of a series of patients operated upon over 28 years ago. Arch. Neurol. (Chic.)18 (1968), 14–19.
Budka, H., and G. Wöber, Primary glioblastoma of the cerebellum. Report of a case associated with multifocal dysplastic glial changes. Acta neurochir. (Wien)31 (1974), 115–121.
Cushing, H., Intracranial Tumors. Springfield, Ill.: Ch. C Thomas. 1932.
Edelman, F. L., F. Aleu, L. C. Scheinberg, J. C. Evans, and L. M. Davidoff, Effect of irradiation on the growth of intracerebral gliomas in mice. J. Neuropath. exp. Neurol.23 (1964), 1–17.
Elvidge, A. R., Long-term survival in the astrocytoma series. J. Neurosurg.28 (1968), 399–404.
Geissinger, J. D., and P. C. Bucy, Astrocytomas of the cerebellum in children. Long-term study. Arch. Neurol. (Chic.)24 (1971), 125–135.
Haymaker, W., L. J. Rubinstein, and J. Miquel, Brain tumors in irradiated monkeys. Acta neuropath. (Berl.)20 (1972), 267–277.
Henschen, F., Tumoren des Zentralnervensystems und seiner Hüllen. In: Handb. spez. path. Anat. Histol., Bd. 13/3, S. 413–1040. Berlin-Göttingen-Heidelberg: Springer. 1955.
Juhász, P., Ein knotiges Kleinhirnoligodendrogliom. Z. ges. Neurol. Psychiat.175 (1942), 745–751.
Koos, W. Th., and M. H. Miller, Intracranial Tumors of Infants and Children. Stuttgart: Thieme. 1971.
Liebner, E. J., J. I. Pretto, M. Hochhauser, and W. Kassaraba, Tumors of the posterior fossa in childhood and adolescence. Their diagnostic and radiotherapeutic patterns. Radiology82 (1964), 193–201.
Marsa, G. W., J. C. Probert, L. J. Rubinstein, and M. A. Bagshaw, Radiation therapy in the treatment of childhood astrocytic gliomas. Cancer32 (1973), 646–655.
Matson, D. D., Surgery of posterior fossa tumors in childhood. Clin. Neurosurg.15 (1968), 247–262.
Netsky, M. G., J. Shapiro, M. Hoffman, B. Corsentino, J. R. Freid, and H. M. Zimmerman, The effect of single doses of Roentgen radiation on experimentally induced gliomas: with a critical review of the effects of Roentgen radiation on gliomas in man. Amer. J. Roentgenol.76 (1956), 351–366.
Oppenheimer, D. R., The effect of irradiation on a medulloblastoma. J. Neurol. Neurosurg. Psychiat.32 (1969), 94–98.
Report of the United Nations Scientific Committee on the Effects of Atomic Radiation, Suppl. No. 13 (A/7613), p. 76–77. New York: United Nations. 1969.
Ringertz, N., and H. Nordenstam, Cerebellar astrocytoma. J. Neuropath. exp. Neurol.10 (1951), 343–367.
Rubinstein, L. J., Tumors of the Central Nervous System. In: Atlas of Tumor Pathology, ser. 2, fasc. 6. Washington, D.C.: AFIP. 1972.
Russell, D. S., and L. J. Rubinstein, Pathology of Tumors of the Nervous System. 3rd ed. London: Edward Arnold Ltd. 1971.
Schulz, M. D., C.-C. Wang, G. F. Zinninger, and M. Tefft, Radiotherapy of intracranial neoplasms. With a special section on the radiotherapeutic management of central nervous system tumors in children. In: Progress in Neurological Surgery, Vol. 2, Eds. Krayenbühl, H., P. E. Maspes, and W. H. Sweet, 319–370. Basel-New York: Karger. 1968.
Scott, R. M., and H. T. Ballantine, Jr., Cerebellar astrocytoma: Malignant recurrence after prolonged postoperative survival. Case report. J. Neurosurg.39 (1973), 777–779.
Tansley, K., and C. W. Wilson, Irradiation of experimental cerebral tumors. II. Some observations on the effect of X-radiation on experimental gliomata in mice. Radiology49 (1947), 62–71.
Tarlov, I. M., Effect of roentgenotherapy on gliomas. Arch. Neurol. Psychiat. (Chic.)38 (1937), 513–536.
Waltz, T. A., and B. Brownell, Sarcoma: A possible late result of effective radiation therapy for pituitary adenoma. Report of two cases. J. Neurosurg.24 (1966), 901–907.
Willis, R. A., The Pathology of the Tumours of Children. Edinburgh-London: Oliver and Boyd. 1962.
Zülch, K. J., Biologie und Pathologie der Hirngeschwülste. In: Handb. Neurochir., Bd. 3, S. 1–702. Berlin-Göttingen-Heidelberg: Springer. 1956.
—, W. A. Harder, and H. Lechtape-Grüter, Zur Pathogenese der Strahlenspätnekrose auf Grund experimenteller und humanpathologischer Beobachtungen. In: Deutscher Röntgenkongreß 1971. Hrsg. Vieten, H., S. 77–78. Stuttgart: Thieme. 1972.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Budka, H. Partially resected und irradiated cerebellar astrocytoma of childhood: Malignant evolution after 28 years. Acta neurochir 32, 139–146 (1975). https://doi.org/10.1007/BF01405911
Issue Date:
DOI: https://doi.org/10.1007/BF01405911