ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 1999 December;43(4):271-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

Malignant cerebellar astrocytomas. Clinico-pathological remarks on 10 cases

Bristot R. ¹, Santoro A. ², Raco A. ¹, Salvati M. ², Puzzilli F. ¹, Delfini R. ¹, Cantore G.

¹ Department of Neurological Sciences, Neurosurgery I, University of Rome “La Sapienza”, Rome, Italy; ² INM Neuromed, Dept. of Neurosurgery, Pozzilli (IS), Italy

Background. Malignant gli­o­ma rep­re­sent ­the 3rd\4th ­most fre­quent ­cause of ­death ­from can­cer. The cer­e­bel­lar ­site is ­rare ­and ­life expec­tan­cy ­with cer­e­bel­lar ana­plas­tic astro­cy­to­ma is ­still dis­mall. The ­growth ­and clin­i­cal-path­o­log­i­cal ­remarks of ­the ­tumor, is sim­i­lar to ­the oth­ers gli­o­mas of ­the cen­tral ner­vous ­system. ­MRI ­with Gd is ­the ­most use­ful diag­nos­tic ­approach ­but ­lacks of spec­i­fic­ity in detect­ing high­ly dif­fer­en­tiat­ed neo­pla­sia are­as.
Methods. Between 1980 ­and 1994 10 cas­es of malig­nant cer­e­bel­lar astro­cy­to­mas ­were oper­at­ed at ­the Neurosurgical Institute, Department of NeuroSciences, of Roma “La Sapienza” University. All ­patients ­were inves­ti­gat­ed ­pre- ­and post­op­er­a­tive­ly by CT ­scan ­with i.v. admin­is­tra­tion ­and/or ­MRI ­with Gd ­when pos­sible.
Results. Of ­the 10 ­patients ­who fol­lowed var­i­ous pro­to­cols, 7 ­died. Average sur­vi­val ­was 13.7 ­months (­range 5-21 ­months). 3 ­patients ­were ­still ­alive 12, 15 ­and 18 ­months ­after sur­gery. In 3 cas­es (50%) ­there ­was ­also radio­log­i­cal evi­dence of spi­nal ­cord spread­ing.
Conclusions. Like cere­bral ­lesions, malig­nant cer­e­bel­lar astro­cy­to­ma ­still a pathol­o­gy ­with a ­real unsat­is­fac­to­ry prog­no­sis. Our expe­ri­ence prob­ably ­showed ­that spi­nal spread­ing is under­sti­mat­ed. For ­this rea­son we ­believe ­that, ­despite ­the lim­it­ed num­ber of cas­es treat­ed so ­far, ­it is impor­tant to ­extend post­op­er­a­tive­ly ­the radio­ther­a­py to ­the ­entire spi­nal ­cord in ­all ­patients.