First local Case Report of a Holocord Pilocytic Astrocytoma – An Uncommon Entity with Management Challenges
DOI:
https://doi.org/10.36552/pjns.v25i3.585Keywords:
Holocord Astrocytoma, Intramedullary Tumors, PilocyticAbstract
Holocord tumors are defined as “Intramedullary spinal tumor extending through the spinal cord with extension from cervicomedullary junction to the conus.” They are uncommon tumors having variable presentation and histology.1,2 Pilocytic astrocytoma (PA) is a slow-growing tumor, mostly benign. It is the diagnosis in 5% to 6% of all intracranial gliomas.3 It is the most common tumor in childhood occurring rarely in the adult population.4 To date, 25 cases of holocord astrocytoma have been reported, of these, 4 were adults and 21 were children. The management of this unusual disease is challenging and debatable.1,5 In this case report, we are describing a case of 14 years old male with holocord grade 1 pilocytic astrocytoma along with its clinical management. To the best of the author’s knowledge, this is the first case of a holocord astrocytoma reported in the country.
References
2. Baran O, Kasimcan O, Sav A, Oruckaptan H. Holocord pilocytic astrocytoma in an adult: a rare case report and review of the literature. World Neurosurgery, 2019 Jun. 1; 126: 369-75.
3. Knight J, De Jesus O. Pilocytic Astrocytoma. [Updated 2021 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing, 2021 Jan. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK560614/
4. Persson O, Fletcher-Sandersjöö A, Burström G, Edström E and Elmi-Terander A. Surgical Treatment of Intra- and Juxtamedullary Spinal Cord Tumors: A Population Based Observational Cohort Study. Front. Neurol. 2019; 10: 814.
5. Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012-2016. Neuro Oncol. 2019 Nov. 1; 21 (Suppl. 5): v1-v100.
6. She D, Lu Y, Xiong J, Geng D, Yin B. MR imaging features of spinal pilocytic astrocytoma. BMC Med Imaging, 2019; 19: 5.
7. Bond KM, Hughes JD, Porter AL, Orina J, Fang S, Parney I. Adult pilocytic astrocytoma: an institutional series and systematic literature review for extent of resection and recurrence. World Neurosurg. 2018; 110: 276-283.
8. Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021; 23 (8): 1231-1251.
9. Ebner FH, Schittenhelm J, Roser F, Scheel- Walter H, Tatagiba M, Schuhmann MU. Management of holocord pilocytic astrocytomas in children and adolescents: an update. Pediatr Neurosurg. 2012; 48: 133-140.
10. Schittenhelm J, Ebner FH, Tatagiba M, et al. Holocord pilocytic astrocytoma—case report and review of the literature. Clin Neurol Neurosurg. 2009; 111: 203-207.
11. Almubarak AO, Ulhaq A, BinDahmash A, Al Shail E. Spinal Pilomyxoid Astrocytoma. Pediatr Neurosurg. 2019; 54 (6): 399-404.
12. Samartzis D, Gillis CC, Shih P, O’Toole JE, Fessler RG. Intramedullary spinal cord tumors: part I—epidemiology, pathophysiology, and diagnosis. Glob Spine J. 2015; 5: 425-435.
13. Kutluk T, Varan A, Kafal? C, Hayran M, Söylemezo?lu F, Zorlu F, Ayd?n B, Yalç?n B, Akyüz C, Büyükpamukçu M. Pediatric intramedullary spinal cord tumors: a single center experience. Eur J Paediatr Neurol. 2015 Jan; 19 (1): 41-7.
14. Zhang, Y. W., Chai, R. C., Cao, R., Jiang, W. J., Liu, W. H., Xu, Y. L., Yang, J., Wang, Y. Z., & Jia, W. Q. (2020). Clinicopathological characteristics and survival of spinal cord astrocytomas. Cancer Medicine, 9 (19): 6996–7006.
15. Chou SC, Kuo MF, Lai DM, Chen CM, Xiao F, Tsuang FY, Yang SH. Contemporary management of pediatric spinal tumors: a single institute's experience in Taiwan in the modern era. J Neurooncol. 2020 Feb; 146 (3): 501-511.
16. Ahmed R, Menezes AH, Torner JC. Role of resection and adjuvant therapy in long-term disease outcomes for low-grade pediatric intramedullary spinal cord tumors. J Neurosurg Pediatr. 2016 Nov; 18 (5): 594-601.
Downloads
Published
Issue
Section
License
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
