Cargando…

Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient

Although pleomorphic xanthoastrocytomas generally carry a fair prognosis, anaplastic transformation has been identified in a subset of cases.We present the case of a patient with primary anaplastic pleomorphic xanthoastrocytoma (APXA) that demonstrated rapid recurrence and diffuse leptomeningeal spr...

Descripción completa

Detalles Bibliográficos
Autores principales: Bounajem, Michael, Cole, Kyril L, Menacho, Sarah T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636185/
https://www.ncbi.nlm.nih.gov/pubmed/34873526
http://dx.doi.org/10.7759/cureus.19186
_version_ 1784608482639478784
author Bounajem, Michael
Cole, Kyril L
Menacho, Sarah T
author_facet Bounajem, Michael
Cole, Kyril L
Menacho, Sarah T
author_sort Bounajem, Michael
collection PubMed
description Although pleomorphic xanthoastrocytomas generally carry a fair prognosis, anaplastic transformation has been identified in a subset of cases.We present the case of a patient with primary anaplastic pleomorphic xanthoastrocytoma (APXA) that demonstrated rapid recurrence and diffuse leptomeningeal spread of disease three months postoperatively, causing severe visual impairment and acute ischemic strokes leading to death.We believe this is the fastest reported time to leptomeningeal dissemination and death from the initial diagnosis. Through this case, we show how anaplastic features can have a highly variable biological effect on disease progression. We believe earlier craniospinal imaging at the time of APXA diagnosis should be pursued to manage disease progression more aggressively with currently recommended adjuvant therapies.
format Online
Article
Text
id pubmed-8636185
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-86361852021-12-05 Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient Bounajem, Michael Cole, Kyril L Menacho, Sarah T Cureus Neurosurgery Although pleomorphic xanthoastrocytomas generally carry a fair prognosis, anaplastic transformation has been identified in a subset of cases.We present the case of a patient with primary anaplastic pleomorphic xanthoastrocytoma (APXA) that demonstrated rapid recurrence and diffuse leptomeningeal spread of disease three months postoperatively, causing severe visual impairment and acute ischemic strokes leading to death.We believe this is the fastest reported time to leptomeningeal dissemination and death from the initial diagnosis. Through this case, we show how anaplastic features can have a highly variable biological effect on disease progression. We believe earlier craniospinal imaging at the time of APXA diagnosis should be pursued to manage disease progression more aggressively with currently recommended adjuvant therapies. Cureus 2021-11-01 /pmc/articles/PMC8636185/ /pubmed/34873526 http://dx.doi.org/10.7759/cureus.19186 Text en Copyright © 2021, Bounajem et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Bounajem, Michael
Cole, Kyril L
Menacho, Sarah T
Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title_full Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title_fullStr Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title_full_unstemmed Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title_short Rapid Diffuse Leptomeningeal Dissemination of an Anaplastic Pleomorphic Xanthoastrocytoma in an Adult Patient
title_sort rapid diffuse leptomeningeal dissemination of an anaplastic pleomorphic xanthoastrocytoma in an adult patient
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636185/
https://www.ncbi.nlm.nih.gov/pubmed/34873526
http://dx.doi.org/10.7759/cureus.19186
work_keys_str_mv AT bounajemmichael rapiddiffuseleptomeningealdisseminationofananaplasticpleomorphicxanthoastrocytomainanadultpatient
AT colekyrill rapiddiffuseleptomeningealdisseminationofananaplasticpleomorphicxanthoastrocytomainanadultpatient
AT menachosaraht rapiddiffuseleptomeningealdisseminationofananaplasticpleomorphicxanthoastrocytomainanadultpatient