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Daniel J Brat - One of the best experts on this subject based on the ideXlab platform.
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Astroblastoma: Radiologic-Pathologic Correlation and Distinction from Ependymoma
2014Co-Authors: John D. Port, Daniel J Brat, Peter C. Burger, Martin G. PomperAbstract:Summary: Astroblastoma is a rare primary glial tumor with a characteristic appearance on neuroradiologic im-ages. Typically, Astroblastomas are large, lobulated, pe-ripheral, supratentorial, solid, and cystic masses with rel-atively little associated vasogenic edema and tumor infiltration for their large size. The solid component of the mass has a bubbly appearance and a T2 signal that is isointense to gray matter. Punctate calcifications are often present. Neuroradiologists should be familiar with the characteristic appearance of this tumor. Astroblastoma is a rare glial tumor estimated to account for 0.45–2.8 % of primary brain gliomas (1). These tumors were initially described by Bailey and Cushing (2) and further characterized by Bailey and Bucy (3); however, in the following decades muc
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An Astroblastoma mimicking a cavernous malformation: case report.
Neurosurgery, 2007Co-Authors: Luis M Tumialán, Daniel J Brat, Arthur J Fountain, Daniel L BarrowAbstract:Astroblastomas are rare glial neoplasms that usually occur in young adults and have a predilection for the cerebral hemispheres. Patients typically present with signs of increased intracranial pressure and seizures. Imaging studies reveal circumscribed, contrast-enhancing tumors that contain both cystic and solid components with variable peritumoral edema. Hemorrhage, which suggested the presence of a vascular lesion in this patient, has not been previously described as a feature of this neoplasm. The authors report the case of a 33-year-old woman who presented with spontaneous intraparenchymal hemorrhage. The collective radiographic data suggested the presence of a cavernous malformation. A right frontotemporal craniotomy was performed under frameless stereotactic image guidance. An Astroblastoma was diagnosed after resection and neuropathological examination. A rare radiological to pathological correlation of Astroblastoma is presented in which the evolving hematoma, as observed on magnetic resonance imaging scans, complicated the radiographic diagnosis of this lesion. The clinical, radiographic, and pathological features of Astroblastomas, as well as the natural history of these rare glial neoplasms, are reviewed. This case illustrates the capacity of Astroblastomas to hemorrhage, disguising the classic radiographic findings typical of this glial neoplasm.
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An Astroblastoma mimicking a cavernous malformation: case report.
Neurosurgery, 2007Co-Authors: Luis M Tumialán, Daniel J Brat, Arthur J Fountain, Daniel L BarrowAbstract:OBJECTIVE: Astroblastomas are rare glial neoplasms that usually occur in young adults and have a predilection for the cerebral hemispheres. Patients typically present with signs of increased intracranial pressure and seizures Imaging studies reveal circumscribed, contrast-enhancing tumors that contain both cystic and solid components with variable perituirioralederna, Hemorrhage, which suggested the presence of a vascular lesion in this patient, has not been previously described as a feature of this neoplasm. CLINICAL PRESENTATION:The authors report the case of a 33-year-old woman who presented with spontaneous intraparenchymal hemorrhage. The collective radiographic data suggested the presence of a cavernous malformation. INTERVENTION: A right frontotemporal craniotomy was performed under frameless stereotactic image guidance. An Astroblastoma was diagnosed after resection and neuropathological examination. CONCLUSION: A rare radiological to pathological correlation of Astroblastoma is presented in which the evolving hematoma, as observed onmagnetic resonance imaging scans, complicated the radiographic diagnosis of this lesion. The clinical, radiographic, and pathological features of Astroblastoma, as well as the natural history of these rare glial neoplasms, are reviewed. This case illustrates the capacity of Astroblastoma to hemorrhage, disguising the classic radiographic findings typical of this glial neoplasm.
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Astroblastoma clinicopathologic features and chromosomal abnormalities defined by comparative genomic hybridization
Brain Pathology, 2006Co-Authors: Daniel J Brat, M Yuichi D Hirose, J Kenneth M D Cohen, G Burt M D Feuerstein, C Peter M D BurgerAbstract:Astroblastomas are uncommon brain tumors whose classification and histogenesis have been debated. Precise criteria for diagnosis have been described only recently, but have not found wide acceptance. We report the clinical, radiographic, and histopathologic features of 20 Astroblastomas, and the chromosomal alterations in seven cases as detected by comparative genomic hybridization (CGH). The tumors occurred both in children and young adults (average age, 14 years), most often as well circumscribed, peripheral, cerebral hemispheric masses. Radiographically, the lesions were contrast-enhancing and solid, often with a cystic component. All were characterized histologically by astroblastic pseudorosettes, and most displayed prominent perivascular hyalinization, regional hyaline changes, and pushing borders in regard to adjacent brain. Tumor cells were strongly immunoreactive for S-100 protein, GFAP, and vimentin. Staining for EMA was focal. Ten of 20 Astroblastomas were classified as "well differentiated" and 10 were classified as "malignant," largely on the basis of hypercellular zones with increased mitotic indices, vascular proliferation, and necrosis with pseudopalisading. All 10 well differentiated lesions and 8 of 10 malignant lesions were completely resected. None of the well differentiated Astroblastomas recurred within the limited follow-up period. Three malignant Astroblastomas recurred, including two incompletely resected tumors, and one that had been totally resected. One patient died of disease following recurrence. The most frequent chromosomal alterations detected by CGH were gains of chromosome arm 20q (4/7 tumors) and chromosome 19 (3/7). The combination of these gains occurred in three, including two well differentiated and one malignant Astroblastoma. Other alterations noted in two tumors each were losses on 9q, 10, and X. These chromosomal alterations are not typical of ependymoma or infiltrating astrocytic neoplasms, and suggest that Astroblastomas may have a characteristic cytogenetic profile in addition to their distinctive clinical, radiographic, and histopathologic features.
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Astroblastoma: radiologic-pathologic correlation and distinction from ependymoma.
AJNR. American journal of neuroradiology, 2002Co-Authors: John D. Port, Daniel J Brat, Peter C. Burger, Martin G. PomperAbstract:Summary: Astroblastoma is a rare primary glial tumor with a characteristic appearance on neuroradiologic images. Typically, Astroblastomas are large, lobulated, peripheral, supratentorial, solid, and cystic masses with relatively little associated vasogenic edema and tumor infiltration for their large size. The solid component of the mass has a bubbly appearance and a T2 signal that is isointense to gray matter. Punctate calcifications are often present. Neuroradiologists should be familiar with the characteristic appearance of this tumor.
Izabela Tarasiewicz - One of the best experts on this subject based on the ideXlab platform.
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A case of Astroblastoma: Radiological and histopathological characteristics and a review of current treatment options.
Surgical neurology international, 2016Co-Authors: Derek C. Samples, Carlos Bazan, James Henry, Izabela TarasiewiczAbstract:Astroblastoma is a rare neuroepithelial tumor that often originates in the cerebral hemisphere of children and young adults. Diagnosis of this obscure neoplasm can be difficult because these tumors are so infrequently encountered and share common radiological and neuropathological features of other glial neoplasms. As such, it should be included in the differential diagnosis of astrocytoma and ependymoma if the clinical and radiographic features suggest it. Standardized treatment of Astroblastomas remains under dispute because of the lack of knowledge regarding the tumor and a paucity of studies in the literature. We present a case of a low-grade Astroblastoma diagnosed in a 30-year-old female with seizures, headache, and vision changes. She underwent gross total resection and, without evidence of high-grade features, adjuvant therapy was not planned postoperatively. Post-operative surveillance suggested early recurrence, warranting referral to radiation therapy. Patient ended up expiring despite adjuvant therapy secondary to extensive recurrence and tumor metastasis. Astroblastoma must be considered in the differential of supratentorial tumors in children and young adults. Treatment of such, as suggested by most recent literature, includes gross total resection and adjuvant radiotherapy for lesions exhibiting high-grade features.
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A case of Astroblastoma: Radiological and histopathological characteristics and a review of current treatment options.
Surgical Neurology International, 2016Co-Authors: Derek C. Samples, James M. Henry, Carlos Bazan, Izabela TarasiewiczAbstract:BACKGROUND Astroblastoma is a rare neuroepithelial tumor that often originates in the cerebral hemisphere of children and young adults. Diagnosis of this obscure neoplasm can be difficult because these tumors are so infrequently encountered and share common radiological and neuropathological features of other glial neoplasms. As such, it should be included in the differential diagnosis of astrocytoma and ependymoma if the clinical and radiographic features suggest it. Standardized treatment of Astroblastomas remains under dispute because of the lack of knowledge regarding the tumor and a paucity of studies in the literature. CASE DESCRIPTION We present a case of a low-grade Astroblastoma diagnosed in a 30-year-old female with seizures, headache, and vision changes. She underwent gross total resection and, without evidence of high-grade features, adjuvant therapy was not planned postoperatively. Post-operative surveillance suggested early recurrence, warranting referral to radiation therapy. Patient ended up expiring despite adjuvant therapy secondary to extensive recurrence and tumor metastasis. CONCLUSIONS Astroblastoma must be considered in the differential of supratentorial tumors in children and young adults. Treatment of such, as suggested by most recent literature, includes gross total resection and adjuvant radiotherapy for lesions exhibiting high-grade features.
Martin G. Pomper - One of the best experts on this subject based on the ideXlab platform.
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Astroblastoma: Radiologic-Pathologic Correlation and Distinction from Ependymoma
2014Co-Authors: John D. Port, Daniel J Brat, Peter C. Burger, Martin G. PomperAbstract:Summary: Astroblastoma is a rare primary glial tumor with a characteristic appearance on neuroradiologic im-ages. Typically, Astroblastomas are large, lobulated, pe-ripheral, supratentorial, solid, and cystic masses with rel-atively little associated vasogenic edema and tumor infiltration for their large size. The solid component of the mass has a bubbly appearance and a T2 signal that is isointense to gray matter. Punctate calcifications are often present. Neuroradiologists should be familiar with the characteristic appearance of this tumor. Astroblastoma is a rare glial tumor estimated to account for 0.45–2.8 % of primary brain gliomas (1). These tumors were initially described by Bailey and Cushing (2) and further characterized by Bailey and Bucy (3); however, in the following decades muc
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Astroblastoma: radiologic-pathologic correlation and distinction from ependymoma.
AJNR. American journal of neuroradiology, 2002Co-Authors: John D. Port, Daniel J Brat, Peter C. Burger, Martin G. PomperAbstract:Summary: Astroblastoma is a rare primary glial tumor with a characteristic appearance on neuroradiologic images. Typically, Astroblastomas are large, lobulated, peripheral, supratentorial, solid, and cystic masses with relatively little associated vasogenic edema and tumor infiltration for their large size. The solid component of the mass has a bubbly appearance and a T2 signal that is isointense to gray matter. Punctate calcifications are often present. Neuroradiologists should be familiar with the characteristic appearance of this tumor.
Junko Hirato - One of the best experts on this subject based on the ideXlab platform.
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Primary spinal cord Astroblastoma: case report.
Journal of neurosurgery. Spine, 2018Co-Authors: Shoko M. Yamada, Sumihito Nobusawa, Yusuke Tomita, Soichiro Shibui, Mikiko Takahashi, Masashi Kawamoto, Junko HiratoAbstract:Astroblastoma is a rare tumor that is thought to occur exclusively in the cerebrum. To the authors’ knowledge, no cases of spinal cord Astroblastoma have been reported. A 20-year-old woman presented with numbness in her legs. MRI demonstrated a 2-cm intramedullary enhancing lesion in the spinal cord at the T-1 level. The patient declined to undergo resection of the tumor because she was able to walk unassisted; however, she returned for surgery 1 month later because she had developed paraplegia with bladder and rectal dysfunction, and MRI showed enlargement of the tumor. Intraoperatively, the border between the tumor and normal tissue was poorly defined. Biopsy samples were obtained for histopathological examinations, and a diagnosis of Astroblastoma with a Ki-67 index of 5% was made. Considering the rapid tumor growth on MRI and remarkable deterioration in her symptoms, the patient was treated with a combination of radiation therapy, temozolomide (TMZ), and bevacizumab. After completion of the combined t...
Natasha R. Acosta - One of the best experts on this subject based on the ideXlab platform.
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Neuroradiologic characteristics of Astroblastoma and systematic review of the literature: 2 new cases and 125 cases reported in 59 publications
Pediatric Radiology, 2016Co-Authors: Danielle A. Cunningham, Lisa H. Lowe, Lei Shao, Natasha R. AcostaAbstract:Background Astroblastoma is a rare tumor of uncertain origin most commonly presenting in the cerebrum of children and young adults. The literature contains only case reports and small series regarding its radiologic features. This systematic review is the largest study of imaging findings of Astroblastoma to date and serves to identify features that might differentiate it from other neoplasms. Objective This study describes the imaging features of Astroblastoma based on a systematic review of the literature and two new cases. Materials and methods We conducted a PubMed and Google Scholar database search that identified 59 publications containing 125 cases of pathology-confirmed Astroblastoma, and we also added two new cases from our own institution. Data collected include patient age, gender, tumor location, morphology, calcifications and calvarial changes. We recorded findings on CT, MRI, diffusion-weighted imaging (DWI), MR spectroscopy, positron emission tomography (PET) and catheter angiography. Results Age at diagnosis ranged 0–70 years (mean 18 years; median 14 years). Female-to-male ratio was 8:1. Of 127 cases, 66 reported CT, 78 reported MRI and 47 reported both findings. Not all authors reported all features, but the tumor features reported included supratentorial in 96% (122/127), superficial in 72% (48/67), well-demarcated in 96% (79/82), mixed cystic–solid in 93% (79/85), and enhancing in 99% (78/79). On CT, 84% (26/31) of Astroblastomas were hyperattenuated, 73% (27/37) had calcifications and 7 cases reported adjacent calvarial erosion. Astroblastomas were hypointense on T1-W in 58% (26/45) and on T2-W in 50% (23/46) of MRI sequences. Peritumoral edema was present in 80% (40/50) of cases but was typically described as slight. Six cases included DWI findings, with 100% showing restricted diffusion. On MR spectroscopy, 100% (5/5) showed nonspecific tumor spectra with elevated choline and decreased N-acetylaspartate (NAA). PET revealed nonspecific reduced uptake of [F-18] 2-fluoro-2-deoxyglucose (^18F-FDG) and increased uptake of [11C]-Methionine in 100% (3/3) of cases. Catheter angiography findings ( n =12) were variable, including hypervascularity in 67%, arteriovenous shunting in 33% and avascular areas in 25%. Conclusion Astroblastomas occur most often in adolescent girls. Imaging often shows a supratentorial, superficial, well-defined, cystic–solid enhancing mass. On CT, most are hyperattenuated, have calcifications, and may remodel adjacent bone if superficial. MRI characteristically reveals a hypointense mass on T1-W and T2-W sequences with restricted diffusion. MR spectroscopy, PET and catheter angiography findings are nonspecific.
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Neuroradiologic characteristics of Astroblastoma and systematic review of the literature: 2 new cases and 125 cases reported in 59 publications.
Pediatric radiology, 2016Co-Authors: Danielle A. Cunningham, Lisa H. Lowe, Lei Shao, Natasha R. AcostaAbstract:Background Astroblastoma is a rare tumor of uncertain origin most commonly presenting in the cerebrum of children and young adults. The literature contains only case reports and small series regarding its radiologic features. This systematic review is the largest study of imaging findings of Astroblastoma to date and serves to identify features that might differentiate it from other neoplasms.
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NIMG-19NEURORADIOLOGIC CHARACTERISTICS OF Astroblastoma: A META-ANALYSIS BASED ON 127 PATIENTS IN 59 PUBLICATIONS.
Neuro-Oncology, 2015Co-Authors: Danielle A. Cunningham, Lisa H. Lowe, Lei Shao, Natasha R. AcostaAbstract:BACKGROUND AND AIMS: Astroblastoma is a rare tumor of uncertain origin most commonly presenting in the cerebral hemispheres of children and young adults. The literature has a few case reports and series regarding its radiologic features. This meta-analysis is the largest review of imaging findings to date and serves to differentiate Astroblastoma from other neoplasms. METHODS: A PubMed search identified reports of Astroblastoma with neuroimaging findings. Data collected included patient age, sex, tumor location, morphology, calcifications, calvarial changes and findings on computed tomography (CT) and magnetic resonance imaging (MRI), including diffusion weighted imaging (DWI). RESULTS: Patient age range at diagnosis was 0-70 years (mean 18 years; median 14 years) with a female:male ratio of 8:1. Of 127 cases, 65 reported CT, 78 reported MRI and 47 reported both CT and MRI findings. Tumor location was supratentorial in 96% (122/127), superficial in 71% (47/66), well-demarcated in 96% (79/82), cystic-solid in 93% (79/85), and enhancing in 99% (77/78). On CT, 84% (26/31) of Astroblastomas were hyperattenuated. Calcifications were present in 77% (27/35), with five cases also reporting adjacent calvarial erosion. Astroblastomas were hypointense on T1 in 58% (25/43) and hypointense on T2 in 50% (23/46). Peritumoral edema was present in 79% (38/48) of cases, but typically described as slight. Few cases reported DWI sequences, with 100% (4/4) showing hyperintensity and decreased ADC values indicating restricted diffusion. CONCLUSION: Most Astroblastomas occur in young females. 96%, 71%, 96%, 93%, 99% are supratentorial, superficial, well-defined, cystic-solid, and enhancing, respectively. On CT, most are hyperattenuated, have calcifications, and if superficial, may erode adjacent bone. On MRI, Astroblastomas are characteristically dark on both T1 and T2 with 100% of cases showing restricted diffusion on DWI.
