Cerebellopontine angle pilocytic astrocytoma in adults: A systematic review.

Surgical neurology international Pub Date : 2024-10-04 eCollection Date: 2024-01-01 DOI:10.25259/SNI_539_2024
Placido Bruzzaniti, Giovanni Pennisi, Pierfrancesco Lapolla, Pietro Familiari, Vincenza Maiola, Claudia Quintiliani, Pierluigi Alò, Michela Relucenti, Biagia La Pira, Giancarlo D'Andrea
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Abstract

Background: In adults, the cerebellopontine angle (CPA) pilocytic astrocytoma (PA) is very rare. This tumor has radiological features similar to those of a vestibular schwannoma in the few cases reported in the literature.

Methods: In this study, we conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and scrutinized all original studies pertaining to pontocerebellar angle PA in adult patients. We conducted an analysis of the clinical, radiological, and molecular components of all eligible articles. We have also reported a case involving a 67-year-old male individual in whom the PA exhibited radiological characteristics similar to an epidermoid cyst.

Results: After the screening phase, we found four cases of PA of the pontocerebellar angle. Three cases were identified that resembled vestibular schwannoma; however, in our case, the tumor resembled an epidermoid cyst. These uncommon tumors exhibit distinctive histological patterns and molecular characteristics (adenosine triphosphate dependent helicase (ATP- dependent helicase)+, Isocitrate dehydrogenase 1-), rendering them a potential differential diagnosis for glioblastoma (GBM).

Conclusion: The CPA PA has rarely been found in adult patients and should be considered in the differential diagnosis of vestibular schwannoma and epidermoid cysts. In these rare cases, the histological characteristics of PA are significant for the differential diagnosis of GBM.

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成人小脑角皮细胞性星形细胞瘤:系统综述。
背景:在成人中,小脑视角(CPA)朝粒细胞星形细胞瘤(PA)非常罕见。在文献报道的少数病例中,这种肿瘤的放射学特征与前庭分裂瘤相似:在本研究中,我们按照《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)的规定进行了系统综述,并仔细研究了所有与成年患者浮小脑角 PA 相关的原始研究。我们对所有符合条件的文章进行了临床、放射学和分子成分分析。我们还报告了一例 67 岁男性患者,其 PA 表现出与表皮样囊肿相似的放射学特征:经过筛选,我们发现了四例小脑桥角 PA 病例。其中三例与前庭裂神经瘤相似,而在我们的病例中,肿瘤与表皮样囊肿相似。这些不常见的肿瘤表现出独特的组织学模式和分子特征(三磷酸腺苷依赖性螺旋酶(ATP- dependent helicase)+、异柠檬酸脱氢酶1-),使它们成为胶质母细胞瘤(GBM)的潜在鉴别诊断对象:结论:CPA PA 在成年患者中很少发现,应在前庭分裂瘤和表皮样囊肿的鉴别诊断中予以考虑。在这些罕见病例中,PA 的组织学特征对 GBM 的鉴别诊断具有重要意义。
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