Astroblastoma, MN1-altered
Updates to Article Attributes
Astroblastoma Astroblastomas areis an uncommon primary neuroepithelial tumourtumours which, along with choroid gliomagliomas of the third ventricle and angiocentric gliomagliomas, isare grouped as other neuroepithelial tumours in the 2007 version of the WHO classification of CNS tumours.
Epidemiology
OccursThey occur at all ages range from early childhood to 6th decade but most commonly seen in children, adolescents, and young adults with mean age between 10-30 years2. Their incidence is estimated in 0.45-2.8% of all neuroglial tumours 4.
Pathology
They are well-demarcated masses with areas of cystic degeneration and necrosis giving it bubbly appearance. Haemorrhage isand adjacent brain infiltration are rare. WHO has not assigned grading to it.
Two distinct histological types were reported 4:
- low-grade type: well differentiated pattern and favourable prognosis
- high-grade type: more anaplastic features with short postoperative survival
Histology
Common histologic finding is perivascular rosettes similar to the ependymomas.
Location
Almost always supratentorial and peripheral.
Radiographic features
They are large, peripherally located, supratentorial lobulated solid cystic masses with little if any associated vasogenic oedema. Multiple cysts give it a bubbly appearance. Calcification is very common and seen in 85% of cases, and usually in a punctate pattern.
MRI
- T1: iso- to hypointense
- T2/FLAIR: heterogeneously hyperintense
- T1 Gd (C+): heterogeneous enhancement
Treatment and prognosis
Surgical resection is treatment of choice with adjuvant radiation therapy and chemotherapy reserved for high-grade lesions. Unless being a high grade lesion recurrence after surgical resection is uncommon4. Metastasis is also very rare.
Differential diagnosis
Possible imaging differential considerations include:
- hemispheric ependymoma
- atypical teratoid/rhabdoid tumour
-
oligodendroglioma
- nodular calcifications instead of punctate calcifications 2
- pleomorphic xanthoastrocytoma
- dysembryoplastic neuroepithelial tumour (DNET)
-<p><strong>Astroblastoma </strong>is an uncommon primary neuroepithelial tumour which, along with <a href="/articles/choroid-glioma-of-the-third-ventricle">choroid glioma of the third ventricle</a> and <a href="/articles/angiocentric-glioma">angiocentric glioma</a>, is grouped as <a href="/articles/cns-tumours-classification-and-grading-who">other neuroepithelial tumours</a> in 2007 version of the <a href="/articles/cns-tumours-classification-and-grading-who">WHO classification of </a><a href="/articles/cns-tumours-classification-and-grading-who">CNS tumours</a>.</p><h4>Epidemiology</h4><p>Occurs at all ages range from early childhood to 6th decade but most commonly seen in children, adolescents, and young adults with mean age between 10-30 years. </p><h4>Pathology</h4><p>They are well-demarcated masses with areas of cystic degeneration and necrosis giving it bubbly appearance. Haemorrhage is rare. WHO has not assigned grading to it.</p><h5>Histology</h5><p>Common histologic finding is perivascular rosettes similar to the <a href="/articles/ependymoma">ependymomas</a>.</p><h5>Location </h5><p>Almost always supratentorial and peripheral.</p><h4>Radiographic features</h4><p>They are large, peripherally located, supratentorial lobulated solid cystic masses with little if any associated vasogenic oedema. Multiple cysts give it a bubbly appearance. Calcification is very common and seen in 85% of cases.</p><h5>MRI</h5><ul>- +<p><strong>Astroblastomas are</strong> an uncommon primary neuroepithelial tumours which, along with <a href="/articles/choroid-glioma-of-the-third-ventricle">choroid gliomas of the third ventricle</a> and <a href="/articles/angiocentric-glioma">angiocentric gliomas</a>, are grouped as <a href="/articles/cns-tumours-classification-and-grading-who">other neuroepithelial tumours</a> in the 2007 version of the <a href="/articles/cns-tumours-classification-and-grading-who">WHO classification of </a><a href="/articles/cns-tumours-classification-and-grading-who">CNS tumours</a>.</p><h4>Epidemiology</h4><p>They occur at all ages range from early childhood to 6th decade but most commonly seen in children, adolescents, and young adults with mean age between 10-30 years <sup>2</sup>. Their incidence is estimated in 0.45-2.8% of all neuroglial tumours <sup>4</sup>.</p><h4>Pathology</h4><p>They are well-demarcated masses with areas of cystic degeneration and necrosis giving it bubbly appearance. Haemorrhage and adjacent brain infiltration are rare.</p><p>Two distinct histological types were reported <sup>4</sup>:</p><ul>
- +<li>low-grade type: well differentiated pattern and favourable prognosis</li>
- +<li>high-grade type: more anaplastic features with short postoperative survival</li>
- +</ul><h5>Histology</h5><p>Common histologic finding is perivascular rosettes similar to the <a href="/articles/ependymoma">ependymomas</a>.</p><h5>Location </h5><p>Almost always supratentorial and peripheral.</p><h4>Radiographic features</h4><p>They are large, peripherally located, supratentorial lobulated solid cystic masses with little if any associated vasogenic oedema. Multiple cysts give it a bubbly appearance. Calcification is very common and seen in 85% of cases, and usually in a punctate pattern.</p><h5>MRI</h5><ul>
-<strong>Gd (C+)</strong>: heterogeneous enhancement</li>-</ul><h4>Treatment and prognosis</h4><p>Surgical resection is treatment of choice with adjuvant radiation therapy and chemotherapy reserved for high-grade lesions. Unless being a high grade lesion recurrence after surgical resection is uncommon. Metastasis is also very rare.</p><h4>Differential diagnosis</h4><p>Possible imaging differential considerations include</p><ul>- +<strong>T1 Gd (C+)</strong>: heterogeneous enhancement</li>
- +</ul><h4>Treatment and prognosis</h4><p>Surgical resection is treatment of choice with adjuvant radiation therapy and chemotherapy reserved for high-grade lesions. Unless being a high grade lesion recurrence after surgical resection is uncommon <sup>4</sup>. Metastasis is also very rare.</p><h4>Differential diagnosis</h4><p>Possible imaging differential considerations include:</p><ul>
-<li><a title="Atypical teratoid/rhabdoid tumour" href="/articles/atypical-teratoidrhabdoid-tumour">atypical teratoid/rhabdoid tumour</a></li>-<li><a href="/articles/oligodendroglioma">oligodendroglioma</a></li>- +<li><a href="/articles/atypical-teratoidrhabdoid-tumour">atypical teratoid/rhabdoid tumour</a></li>
- +<li>
- +<a href="/articles/oligodendroglioma">oligodendroglioma</a><ul><li>nodular calcifications instead of punctate calcifications <sup>2</sup>
- +</li></ul>
- +</li>
- +<li><a href="/articles/dysembryoplastic-neuroepithelial-tumour">dysembryoplastic neuroepithelial tumour (DNET)</a></li>
References changed:
- 4. Agarwal V, Mally R, Palande DA et-al. Cerebral astroblastoma: A case report and review of literature. Asian J Neurosurg. 2012;7 (2): 98-100. <a href="http://dx.doi.org/10.4103/1793-5482.98657">doi:10.4103/1793-5482.98657</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410171">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22870162">Pubmed citation</a><span class="auto"></span>
Image 3 CT (non-contrast) ( create )
Image 4 MRI (T2) ( create )
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