Angiocentric Glioma in an Elderly Patient: Case Report and Review of the Literature

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• 作者：Lain Hermes Gonzalez-Quarante¹ ; ^{lainhermesgq@gmail.com} ; Carlos Fern&aacute ; ndez Carballal¹ ; Vijay Agarwal³ ; Antonio J. Vargas Lopez¹ ; Oscar Lucas Gil de Sagredo del Corral¹ ; Emma Sola Vendrell²
• 关键词：Angiocentric glioma ; Elderly patient ; Grade I glioma ; Intractable seizures ; Low-grade glioma
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：755.e5-755.e10
• 全文大小：3202 K
• 卷排序：97

文摘

Angiocentric glioma is a very uncommon low-grade tumor, predominantly occurring in pediatric patients, that was first described in 2005 and was codified 2 years later as a new central nervous system primary tumor. We herein report an exceptionally rare case of an elderly patient with angiocentric glioma. Only one additional case of angiocentric glioma in a patient older than 65 years has been hitherto reported.Case DescriptionAn 83-year-old male patient presented at our institution complaining of a 1-month history of progressive weakness of his right hand and difficulty performing fine movements. Magnetic resonance imaging of the brain was performed, and fluid-attenuated inversion recovery and T2-hyperintense diffuse cortico-subcortical lesion were reported. A neuronavigation-guided frontal craniotomy was performed to expose the premotor cortex, motor cortex, Rolandic sulcus, and postcentral gyrus. Intraoperative mapping showed that the tumor was close to the shoulder area. Therefore, only partial resection was safely feasible. Pathology report described astrocytic neoplastic cells affecting mainly the cortex and piamater with the classic finding of subpial palisading, with no endothelial invasion or atypia. Neoplastic cells were positive for glial fibrillary acidic protein, epithelial membrane antigen, Wilms tumor protein-1, P16, and P53. Low proliferative activity was seen (Ki-67 < 2%). Abundant gliovascular structures were also reported.ConclusionsConsidering the morphologic and immunohistochemical data, the final pathologic diagnosis was angiocentric glioma. Furthermore, a thorough review of the literature was performed with the purpose of updating and summarizing the main clinical, radiologic, and pathologic features of this rare tumor.