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Review
. 2017 Apr;6(2):107-110.
doi: 10.2217/cns-2016-0030.

Adult pilocytic astrocytoma of conus medullaris: clinical considerations and review of the literature

José Pedro Lavrador  1   2 , Edson Oliveira  1 , José Pimentel  3 , Sérgio Livraghi  1   4
Affiliations
Review

Adult pilocytic astrocytoma of conus medullaris: clinical considerations and review of the literature

José Pedro Lavrador et al. CNS Oncol. 2017 Apr.

Abstract

Astrocytomas are responsible for 30% of all primitive intramedullary tumors with cervicothoracic predominance. However, only about one hundred cases of intramedullary pilocytic astrocytomas were described. The authors described the case of a 69 year-old patient presenting with a broad-base gait, bilateral pain and dysesthesia of inferior limbs with a diagnosis of an intra-axial cystic lesion centered to the conus medullaris, diagnosed as pilocytic astrocytoma of conus medullaris (PACM) after surgery. To the best of our knowledge, only two previous reports concerning PACM were made. As benign lesions associated with long survivals, function should be the mainstay of treatment of PACM. Surgical resection should be performed. Adjuvant radiotherapy or chemotherapy has no establish role in pilocytic astrocytic lesions.

Keywords: chemotherapy; conus medullaris; intramedullary spinal cord tumor; pilocytic astrocytoma; radiotherapy.

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Conflict of interest statement

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. T2 Sagital (A) and T1 Axial (B) images showing a cystic lesion centered to the conus medullaris, hypointense in T1 and hyperintense in T2.
No contrast enhancement images are available as patient refused contrast injection.
<b>Figure 2.</b>
Figure 2.
T2 Sagital (A), T2 Axial (B) and T1 post-Gad Axial (C) images showing reduction of mass effect from cystic lesion and no contrast uptake after Gadolinium infection.
<b>Figure 3.</b>
Figure 3.. Histology.
(A) moderately compact bipolar neoplastic astrocyts with long, hair-like processes. No signs of anaplasia (H&E x40); (B) strongly glial fibrillary acidic protein immunopositivity (x40).
See this image and copyright information in PMC

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