High-grade astroblastoma in a child: Report of one case and review of literature

Abstract

Background: Astroblastoma is a rare glial neoplastic lesion that affects children and adolescents; its histogenesis remains uncertain. It is considered to account for 0.5% of all glial neoplasms, and two different subtypes have been defined based upon histologic characteristics.

Case description: We present the case of a 9-year-old girl who presented with headache, motor symptoms, and seizures few days before she was admitted to our institution. Computed tomography (CT) and magnetic resonance imaging (MRI) scans showed an intra-axial heterogeneous frontoparietal lesion with a striking "bubbly" appearance in MRI T2-weighted sequences and features of intracranial hypertension. Gross total resection of the tumor was achieved and the histopathologic diagnosis revealed high-grade astroblastoma. We reviewed the current published cases of astroblastoma to highlight the demographic, clinical, radiologic, and pathologic data.

Conclusion: Astroblastomas are a distinct clinicopathologic entity, with well-described radiologic, pathologic, and cytogenetic features. Its recurrence is high and efforts must be made to elucidate the role and usefulness of radiotherapy and chemotherapy in these tumors.

Keywords: Astroblastoma; glial tumors; pediatric tumors; supratentorial tumor.

Figure 1

Axial non-contrast CT scan reveals a relatively well-demarcated frontoparietal tumor with mixed densities, with solid and cystic areas and minimal peripheral edema, but displacement of midline structures

Figure 2

Axial T1-weighted (a) and contrast (b) MRI demonstrates a heterogeneous well-circumscribed frontoparietal tumor with rim enhancement and enhancement of the solid and cystic areas of the tumor

Figure 3

Axial T2-weighted MRI shows a heterogeneous, predominantly hyperintense lesion with white matter, with minimal surrounding edema and “bubbly” appearance (a). Coronal T2- weighted MRI reveals a strikingly “bubbly” appearance and midline shift (b)

Figure 4

Histopathologic analysis revealed a papillary neoplasm composed of mildly pleomorphic cells with a striking perivascular array of pseudorosettes (a, 10×). Also, prominent endothelial hyperplasia and hyalinized vessel walls were found (b, 4×) (hematoxylin/eosin)