KMID : 1001920120510020109
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Journal of Korean Neurosurgical Society 2012 Volume.51 No. 2 p.109 ~ p.112
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Leptomeningeal Dissemination of a Low-Grade Brainstem Glioma without Local Recurrence
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Moon Jung-Ho
Jung Tae-Young Jung Shin Jang Woo-Youl
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Abstract
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It is rare for low-grade gliomas to disseminate to the leptomeninges. However, low-grade gliomas with dissemination to the leptomeninges have been occasionally reported in children, and have generally been associated with local recurrence. A 16-year-old boy sought evaluation for diplopia and gait disturbance. A brain magnetic resonance imaging (MRI) revealed pontine mass, which was proved to be fibrillary astrocytoma on biopsy, later. Radiation therapy (5400 cGy) was given and the patient¡¯s symptoms were improved. He was followed-up radiologically for brain lesion. Seven months after diagnosis he complained of back pain and gait disturbance. A brain MRI showed a newly-developed lesion at the left cerebellopontine angle without an interval change in the primary lesion. A spinal MRI demonstrated leptomeningeal dissemination of the entire spine. Radiation therapy (3750 cGy) to the spine, and adjuvant chemotherapy with a carboplatin plus vincristine regimen were administered. However, he had a progressive course with tumoral hemorrhage and expired 13 months after diagnosis. We report an unusual case of a low-grade brainstem glioma with spinal dissemination, but without local recurrence, and a progressive course associated with hemorrhage.
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KEYWORD
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Children, Leptomeningeal dissemination, Low-grade glioma, Recurrence
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