Más de 80 % de los astrocitomas ubicados en el cerebelo son de grado bajo ( pilocíticos de grado I) y, con frecuencia, quísticos; la mayoría de los restantes son . de un astrocitoma quistico grado I. El enfermo ha estado libre de ataques durante 10s dos aiios que han transcurrido desde la intervencion quirdrgica y sin . Everolimus y astrocitoma subependimario de células gigantes con del componente sólido, no hay evidencia del componente quístico.
|Published (Last):||7 November 2008|
|PDF File Size:||9.59 Mb|
|ePub File Size:||7.31 Mb|
|Price:||Free* [*Free Regsitration Required]|
During recent years, we have witnessed many technological advances in electronic publication. The accessibility and wide diffusion of on-line publication will provide the opportunity for our scientific colleagues, not only in Latin America, but throughout the world, to share the knowledge and skills of our Mexican surgical community, as well as to provide authors from other countries with a forum for participating in our Journal, in order that we may gain knowledge of surgical specialties throughout the world.
Manuscripts will be accepted in Spanish and in English, and will be translated to English or Spanish for on-line publication. Guidelines for manuscript submission can be accessed in this website.
We are confident that this evolution in publication will serve the needs of the international community, as well as to provide our Mexican scientists with greater visibility throughout the global community. The Mexican Academy of Surgery is pleased to offer this on-line publication without fees or subscription. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. SRJ is a prestige metric based on the idea that not all citations are the same.
SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.
Pilocytic astrocytoma is a rare tumour, usually occurring in paediatric ages, and mainly located in the posterior fossa. It can cause hydrocephalus and intracranial hypertension and, less frequently, seizures, or a focal neurological deficit. The main imaging study by magnetic resonance imaging, which shows a tumour with solid and cystic components without peri-lesional swelling. The election treatment is surgical, and the patient is considered cured if a total resection is accomplished.
The case is presented of year-old female patient with a supratentorial pilocytic astrocytoma and epilepsy. Histopathology reported a low grade glial proliferation, with an extensive fibrillar matrix, small cells without atypia, extensive calcifications and piloid areas consisting of bipolar fusiform cells, and some Rosenthal fibres.
There were also spongiotic areas consisting of multipolar cells and associated microcysts. The final report was a pilocytic astrocytoma. Pilocytic astrocytoma is more frequent in paediatric patients and in the posterior fossa. The case presented is of a young female adult with supratentorial location, making it a special case.
The surgery achieved a total resection. The long-term prognosis is good, but it is necessary to perform a follow-up, particularly in adult patients because of a higher risk of recurrence. Pilocytic astrocytoma is classified by the World Health Organisation as a grade I astrocytarian tumour, within the group of those derived from neuroepithelial tissue.
It is a well-circumscribed, slow growing tumour. In general, a patient is considered cured when a complete tumour resection has been performed. The most common site is the posterior fossa in paediatric patients.
We present the case of a young adult patient with a supratentorial pilocytic astrocytoma and epilepsy. This is the case of a 22 year-old female who presented with astrocito,a current condition one week before her arrival to hospital, with generalised onset of a tonic-clonic seizure which caused mild head trauma.
She subsequently had two further seizures. The patient denied having had any other symptoms. Neurological examination revealed that the patient’s mental functions, cranial nerve functions, motor system, senses and cerebellum were all within normal limits. An EEG showed abnormal activity and treatment was initiated with 1 g of levetiracetam every 12 h. Simple and contrasted magnetic resonance of the skull was performed, where a lesion in the first gyrus of the right astrpcitoma lobe was observed.
This was observed as a hypertense ring on simple T1 imaging, as a ring on contrast enhanced T1, with a hypointense centre and no perilesional oedema on T2 and FLAIR signals Fig. Computed tomography revealed calcification on the periphery, mainly towards the medial surface of the lesion. Preoperative studies were carried out in which thrombocytopenia was identified in 21, counts. It was evaluated by the haematology unit which diagnosed idiopathic thrombocytopenic purpura.
The patient received treatment with platelet apheresis, corticosteroids and immunoglobulin. During her hospital stay and prior to surgery of the central nervous wstrocitoma, she presented with intense pain in the right hypochondrium and was therefore assessed by general surgery. She was diagnosed through questioning, physical examination and abdominal scan with an aseptic cholecystitis.
She suffered from painful hepatomegaly and presented with a drop in haemoglobin. These symptoms were resolved by conservative treatment.
Magnetic resonance of the skull. Once surgery had been authorised it was performed with a Falconer type right incision, a temporal craniotomy and complete resection of the lesion by microsurgery with the use quisticco a neuronavegator with quisitco and ultrasonic aspirator Fig. There were no events or complications during the procedures. The patient was discharged neurologically intact. She evolved satisfactorily, with no seizures, and is still taking 1 g of oral levetiracetam every 12 h.
She has been followed up now for a little over 5 years. Postoperative magnetic resonance of the skull which shows total resection of the tumour: Histopathology reported a low grade glial proliferation Fig. There were also spongiotic areas consisting of multipolar cells and associated asrrocitoma Fig. Immunohistochemistry analysis was performed in astricitoma a glial fibrillary acidic protein of the positive glia in the fibrillar matrix and neoplastic cells was found.
The final report was a pilocytic astrocytoma Fig. Spongiotic areas consisting of multipolar cells and associated microcysts. We present the case of a young adult patient with a right temporal pilocytic astrocytoma, who began with epilepsy. The most common quixtico astrocytomas in paediatric patients compared to adults, as demonstrated in several reported series, 2—6 corresponds to 2.
Several series report a slightly higher incidence in men, than in women, as was reported by Ohgaki et al. There is a clear correlation between the patient’s age and tumour site. Infratentorial quixtico more common in paediatric age patients, 6,8 and indistinct in adults, but with a tendency to be supratentorial, 4,10 and often in the temporal lobes.
Quiistico posterior fossa is the most common site The presentation of symptoms is generally insidious, due to slow tumour growth. Clinical presentation in hemispheric site include: Intraparenchymal bleeding has also been described as a form of presentation, but it is rare. Grade I reflects the absence of malignant morphological characteristics.
The first genetic association with the pilocytic astrocytoma was the mutation of gene NF1 and the type I NF-1 neurofibromatosis. This alteration is associated with a more indolent behaviour. One tool which may help with differential diagnosis of in pilocytic astrocytoma and other tumours is spectroscopy.
Pilocytic astrocytomas show a lower creatine peak compared with that found in ependymoma quisico medulloblastoma radiology. A tendency of higher tCho levels in adults has been reported compared with paediatric age patients, who in contrast usually have a higher tCr peak. The most frequently differential astroctoma include relatively well circumscribed tumours such as: Treatment for the patient with pilocytic astrocytoma is total resection, which may be performed in a high number of patients, even when it is in an area of complex access.
The patient is considered cured when resection qistico complete. If incomplete, chemotherapy and radiotherapy are helpful. When radical surgery is not possible, particularly when the site is profound or in a critical position, radiosurgery plays an essential role in cases of minor residual tumour.
Astrocitoma pilocítico – Wikipedia, la enciclopedia libre
A more favourable clinical course is likely when the lesion is superficial and if only one lobe is affected, compared with more profound or midline lesions.
Local reappearance is rare, as is cerebrospinal fluid dissemination or malignant transformation. Malignant transformation to anaplastic astrocytoma in patients with pilocytic astrocytoma has been described, particularly in adults who have received adjuvant radiotherapy, but without this association being definitive.
Routine molecular analysis of adult pilocytic astrocytoma has been recommended, combined quistic histopathological analysis and neuroimaging, to sharpen prognosis. The presented case is interesting since, in general, a pilocytic astrocytoma is not suspected when the lesion is supratentorial. The age, tumour site, radiologic characteristics and presentation form atsrocitoma help us to keep this diagnosis in mind.
The authors have no conflict of interests to declare. Please cite this article as: Previous article Next article. September – October Pages This item has received. Under a Creative Commons license. Show more Show less. Background Pilocytic astrocytoma is a rare tumour, usually occurring in paediatric ages, and mainly located in the posterior fossa. The election treatment is surgical, and the patient is considered cured if a total resection is accomplished.
Clinical case The case is presented of year-old female patient with a supratentorial pilocytic astrocytoma and epilepsy.
There was a problem providing the content you requested
The final report was a pilocytic astrocytoma. Conclusions Pilocytic astrocytoma is more frequent in paediatric patients and in the posterior fossa. The long-term prognosis is good, but it qiistico necessary to perform a follow-up, particularly in adult patients because of a higher risk of recurrence. Background Pilocytic astrocytoma is classified by the World Health Organisation as a grade I astrocytarian tumour, within the group of those derived from neuroepithelial tissue.
Objective We present the case of a young adult patient with a supratentorial pilocytic astrocytoma and epilepsy. Clinical case This is the case of a 22 year-old female who presented with her current condition one week before her arrival to hospital, with generalised onset of a tonic-clonic seizure which caused mild head trauma.
Neurological examination revealed that the patient’s mental functions, cranial nerve functions, motor system, senses and cerebellum were all within normal limits. These symptoms were resolved by conservative treatment. The WHO classification of tumors of the central nervous system.