Low-grade astrocytoma with neuraxis dissemination at diagnosis

A. Gajjar, R. Bhargava, J. J. Jenkins, R. Heideman, R. A. Sanford, J. W. Langston, A. W. Walter, J. F. Kuttesch, M. Muhlbauer, L. E. Kun

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Little is known about low-grade astrocytoma with neuraxis dissemination at diagnosis. A review of medical records identified this phenomenon in eight of 150 pediatric patients evaluated between 1985 and 1994 for histologically confirmed low-grade astrocytoma. These patients (five male and three female) ranged in age from 5 months to 20 years (median 8 years). Symptoms of neuraxis disease were minimal or absent. Primary tumor sites were the hypothalamus in four cases, brainstem/spinal cord in three, and temporal lobe in one. Patterns of dissemination (evaluated by computerized tomography and/or magnetic resonance imaging techniques) appeared to be related to the primary site: hypothalamic tumors metastasized along the ventricular cerebrospinal fluid pathways, and tumors in other locations disseminated along subarachnoid pathways. Following initial treatment with chemotherapy (in three), partial resection (in one), radiation therapy (in three), and chemotherapy plus irradiation (in one), four patients required salvage therapy for progressive or recurrent disease. Seven of the eight patients are alive with stable or progressive disease 6 to 105 months postdiagnosis (median 15 months). Low-grade astrocytoma with initial neuraxis dissemination is responsive to chemotherapy and radiation, a proportion showing periods of stable disease. The optimum therapy or combination of therapies remains unclear.

Original languageEnglish (US)
Pages (from-to)67-71
Number of pages5
JournalJournal of Neurosurgery
Volume83
Issue number1
DOIs
StatePublished - Jan 1 1995

Fingerprint

Astrocytoma
Drug Therapy
Hypothalamic Neoplasms
Salvage Therapy
Temporal Lobe
Hypothalamus
Brain Stem
Medical Records
Cerebrospinal Fluid
Neoplasms
Spinal Cord
Radiotherapy
Therapeutics
Tomography
Magnetic Resonance Imaging
Radiation
Pediatrics

Keywords

  • dissemination
  • low-grade astrocytoma
  • neuraxis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Gajjar, A., Bhargava, R., Jenkins, J. J., Heideman, R., Sanford, R. A., Langston, J. W., ... Kun, L. E. (1995). Low-grade astrocytoma with neuraxis dissemination at diagnosis. Journal of Neurosurgery, 83(1), 67-71. https://doi.org/10.3171/jns.1995.83.1.0067

Low-grade astrocytoma with neuraxis dissemination at diagnosis. / Gajjar, A.; Bhargava, R.; Jenkins, J. J.; Heideman, R.; Sanford, R. A.; Langston, J. W.; Walter, A. W.; Kuttesch, J. F.; Muhlbauer, M.; Kun, L. E.

In: Journal of Neurosurgery, Vol. 83, No. 1, 01.01.1995, p. 67-71.

Research output: Contribution to journalArticle

Gajjar, A, Bhargava, R, Jenkins, JJ, Heideman, R, Sanford, RA, Langston, JW, Walter, AW, Kuttesch, JF, Muhlbauer, M & Kun, LE 1995, 'Low-grade astrocytoma with neuraxis dissemination at diagnosis', Journal of Neurosurgery, vol. 83, no. 1, pp. 67-71. https://doi.org/10.3171/jns.1995.83.1.0067
Gajjar A, Bhargava R, Jenkins JJ, Heideman R, Sanford RA, Langston JW et al. Low-grade astrocytoma with neuraxis dissemination at diagnosis. Journal of Neurosurgery. 1995 Jan 1;83(1):67-71. https://doi.org/10.3171/jns.1995.83.1.0067
Gajjar, A. ; Bhargava, R. ; Jenkins, J. J. ; Heideman, R. ; Sanford, R. A. ; Langston, J. W. ; Walter, A. W. ; Kuttesch, J. F. ; Muhlbauer, M. ; Kun, L. E. / Low-grade astrocytoma with neuraxis dissemination at diagnosis. In: Journal of Neurosurgery. 1995 ; Vol. 83, No. 1. pp. 67-71.
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