Epidemiology
The incidence of spinal cord astrocytoma is reported to be 0.8 to 2.5 out of every 100,000 people per year [PMID:21927564].
Clinical Presentation
A 3-year-old boy presented with headaches, vomiting, lethargy, and papilledema indicative of communicating hydrocephalus, rather than spinal cord-related symptoms [PMID:15886510].
The study included children with a median age of 7 years (range 1-15 years) diagnosed with high-grade astrocytomas [PMID:9452226].
Diagnosis
This case report highlights unique imaging findings of concurrent bone metastasis from a spinal cord astrocytoma at the time of initial diagnosis, offering novel diagnostic perspectives [PMID:21927564].
CSF studies during shunt placement were normal, but lumbar puncture CSF showed high protein levels and suspicious cytology for malignancy, aiding in diagnosis [PMID:15886510].
Management
The patient underwent subtotal resection, followed by chemotherapy and radiation therapy, resulting in no residual tumor on MRI and persistent leptomeningeal enhancement without neurological decline over 16 months [PMID:15886510].
Eighteen children with newly diagnosed high-grade astrocytomas received two initial cycles of '8-in-1' chemotherapy followed by eight additional cycles and radiotherapy [PMID:9452226].
Complications
Systemic metastasis from a spinal cord astrocytoma, particularly concurrent bony metastasis at the time of initial diagnosis, is extremely uncommon and has not been previously reported [PMID:21927564].
Prognosis & Follow-up
The abstract mentions conclusions regarding 5-year progression, suggesting an evaluation of long-term outcomes was planned [PMID:9452226].
References
1 Park AY, Kim H, Chung TS, Yoon CS, Ryu YH, Cho YE et al.. A spinal cord astrocytoma and its concurrent osteoblastic metastases at the time of the initial diagnosis: a case report and literature review. Korean journal of radiology 2011. link 2 Vassilyadi M, Michaud J. Hydrocephalus as the initial presentation of a spinal cord astrocytoma associated with leptomeningeal spread. Pediatric neurosurgery 2005. link 3 Allen JC, Aviner S, Yates AJ, Boyett JM, Cherlow JM, Turski PA et al.. Treatment of high-grade spinal cord astrocytoma of childhood with "8-in-1" chemotherapy and radiotherapy: a pilot study of CCG-945. Children's Cancer Group. Journal of neurosurgery 1998. link