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Leptomeningeal dissemination of cerebellar malignant astrocytomas

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Abstract

Primary malignant astrocytomas of the cerebellum are extremely rare, and the dissemination patterns and effectiveness of postoperative radiation therapy are unclear. Five consecutive cases of histologically proven cerebellar malignant astrocytoma, two anaplastic astrocytomas, one anaplastic pilocytic astrocytoma, and two glioblastomas, were treated between 1997 and 2001. Four patients underwent surgical removal, local irradiation, and chemotherapy, and one patient with anaplastic pilocytic astrocytoma received subtotal removal followed by gamma knife radiosurgery for the residual tumor. Two patients had no recurrence at the primary site. All patients developed leptomeningeal dissemination. Four patients had supratentorial dissemination and two patients had spinal metastases. The time interval between the diagnosis of the primary cerebellar tumor and the diagnosis of leptomeningeal dissemination was 5–29 months (mean 14.6 ± 10.4 months). All patients died at 10–38 months (mean survival 22.2 ± 13.6 months). Intensive treatment including chemotherapy and radiotherapy may be required in cerebellar malignant astrocytomas, considering the high incidence of symptomatic leptomeningeal dissemination.

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References

  1. Carmichael F: Cerebral gliomata. J Pathol 31: 493-510, 1928

    Google Scholar 

  2. Aziz TZ, Stoddart M: Cerebellar glioblastoma multiforme: a report of two cases and review of the literature. West Engl Med J 105(2): 39-42, 1990

    Google Scholar 

  3. Chamberlain MC, Silver P, Levin VA: Poorly differentiated gliomas of the cerebellum. A study of 18 patients. Cancer 65(2): 337-340, 1990

    Google Scholar 

  4. Chin HW, Maruyama Y, Tibbs P, Markesbery W, Young B: Cerebellar glioblastoma in childhood. J Neuro-Oncol 2(1): 79-84, 1984

    Google Scholar 

  5. Djalilian HR, Hall WA: Malignant gliomas of the cerebellum: an analytic review. J Neuro-Oncol 36(3): 247-257, 1998

    Google Scholar 

  6. Dohrmann GJ, Farwell JR, Flannery JT: Glioblastoma multiforme in children. J Neurosurg 44(4): 442-448, 1976

    Google Scholar 

  7. Fresh CB, Takei Y, O'Brien MS: Cerebellar glioblastoma in childhood: case report. J Neurosurg 45(6): 705-708, 1976

    Google Scholar 

  8. Georges PM, Noterman J, Flament-Durand J: Glioblastoma of the cerebellum in children and adolescents: case report and review of the literature. J Neuro-Oncol 1(3): 275-278, 1983

    Google Scholar 

  9. Hegedus K, Molnar P: Primary cerebellar glioblastoma multiforme with an unusually long survival: case report. J Neurosurg 58(4): 589-592, 1983

    Google Scholar 

  10. Katz DS, Poe LB, Winfield JA, Corona RJ: A rare case of cerebellar glioblastoma multiforme in childhood: MR imaging. Clin Imaging 19(3): 162-164, 1995

    Google Scholar 

  11. Kopelson G: Cerebellar glioblastoma. Cancer 50(2): 308-311, 1982

    Google Scholar 

  12. Kulkarni AV, Becker LE, Jay V, Armstrong DC, Drake JM: Primary cerebellar glioblastomas multiforme in children: report of four cases. J Neurosurg 90(3): 546-550, 1999

    Google Scholar 

  13. Kuroiwa T, Numaguchi Y, Rothman MI, Zoarski GH, Morikawa M, Zagardo MT, Kristt DA: Posterior fossa glioblastoma multiforme: MR findings. AJNR Am J Neuroradiol 16(3): 583-589, 1995

    Google Scholar 

  14. Levine SA, McKeever PE, Greenberg HS: Primary cerebellar glioblastoma multiforme. J Neuro-Oncol 5(3): 231-236, 1987

    Google Scholar 

  15. Luccarelli G: Glioblastoma multiforme of the cerebellum: description of three cases. Acta Neurochir (Wien) 53(1-2): 107-116, 1980

    Google Scholar 

  16. Pang D, Ashmead JW: Extraneural metastasis of cerebellar glioblastoma multiforme. Neurosurgery 10(2): 252-257, 1982

    Google Scholar 

  17. Sposto R, Ertel IJ, Jenkin RDT, Boesel CP, Venes JL, Ortega JA, Evans AE, Wara W, Hammond D: The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial.A report from the Childrens Cancer Study Group. J Neuro-Oncol 7(2): 165-177, 1989

    Google Scholar 

  18. Salazar OM: Primary malignant cerebellar astrocytomas in children: a signal for postoperative craniospinal irradiation. Int J Radiat Oncol Biol Phys 7(12): 1661-1665, 1981

    Google Scholar 

  19. Sinoda J, Yamada H, Sakai N, Ando T, Hirata T, Hirayama H: malignant cerebellar astrocytic tumours in children. Acta Neurochir (Wien) 98(1-2): 1-8, 1989

    Google Scholar 

  20. Steinberg GK, Shuer LM, Conley FK, Hanbery JW: Evolution and outcome in malignant astroglial neoplasms of the cerebellum. J Neurosurg 62(1): 9-17, 1985

    Google Scholar 

  21. Zito JL, Siva A, Smith TW, Leeds M, Davidson R: Glioblastoma of the cerebellum. Computed tomographic and pathologic considerations. Surg Neurol 19(4): 373-378, 1983

    Google Scholar 

  22. Kleihues P, Burger PC, Scheithauer BW (eds): Histological typing of tumors of the central nervous system, 2nd edn. In: World Health Organization. International Histological Classification of Tumors. Springer-Verlag, New York, 1993, pp 11-15

    Google Scholar 

  23. Awad I, Bay JW, Rogers L: Leptomeningeal metastasis from supratentorial malignant gliomas. Neurosurgery 19(2): 247-251, 1986

    Google Scholar 

  24. Vertosick FT, Selker RG: Brain stem and spinal metastases of supratentorial glioblastoma multiforme: a clinical series. Neurosurgery 27(4): 516-522, 1990

    Google Scholar 

  25. Yung WA, Horten BC, Shapiro WR: Meningeal gliomatosis: a review of 12 cases. Ann Neurol 8(6): 605-608, 1980

    Google Scholar 

  26. Kopelson G, Linggood R: Infratentorial glioblastoma: the role of neuroaxis irradiation. Int J Radiat Oncol Biol Phys 8(6): 999-1003, 1982

    Google Scholar 

  27. Salazar OM, Rubin P: The spread of glioblastoma multiforme as a determining factor in the radiation treated volume. Int J Radiat Oncol Biol Phys 1(7-8): 627-637, 1976

    Google Scholar 

  28. Nakagawa K, Aoki Y, Fujimaki T, Tago M, Terahara A, Karasawa K, Sakata K, Sasaki Y, Matsutani M, Akanuma A: High-dose conformal radiotherapy influenced the pattern of failure but did not improve survival in glioblastoma multiforme. Int J Radiat Oncol Biol Phys 40(5): 1141-1149, 1998

    Google Scholar 

  29. Arita N, Taneda M, Hayakawa T: Leptomeningeal dissemination of malignant gliomas: incidence, diagnosis and outcome. Acta Neurochir (Wien) 126(2-4): 84-92, 1994

    Google Scholar 

  30. Kato H, Fujimura M, Kumabe T, Ishioka C, Kanamaru R, Yoshimoto T: PTEN gene mutation and high MIB-1 labeling index may contribute to dissemination in patients with glioblastoma. J Clin Neurosci (in press)

  31. Brada M, Hoang-Xuan K, Rampling R, Dietrich PY, Dirix LY, Macdonald D, Heimans JJ, Zonnenberg BA, Bravo-Marques JM, Henriksson R, Stupp R, Yue N, Bruner J, Dugan M, Rao S, Zaknoen S: Multicenter phase II trial of temozolomide in patients with glioblastoma multiforme at first relapse. Ann Oncol 12(2): 259-266, 2001

    Google Scholar 

  32. Yung WK, Albright RE, Olson J, Fredericks R, Fink K, Prados MD, Brada M, Spence A, Hohl RJ, Shapiro W, Glantz M, Greenberg H, Selker RG, Vick NA, Rampling R, Friedman H, Phillips P, Bruner J, Yue N, Osoba D, Zaknoen S, Levin VA: A phase II study of temozolomide versus procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer 83(5): 588-593, 2000

    Google Scholar 

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Endo, H., Kumabe, T., Jokura, H. et al. Leptomeningeal dissemination of cerebellar malignant astrocytomas. J Neurooncol 63, 191–199 (2003). https://doi.org/10.1023/A:1023983518341

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  • DOI: https://doi.org/10.1023/A:1023983518341

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