Astrocytomas IDH-mutant of posterior cranial fossa, clinical presentation, imaging features and onco-functional balance in surgical management.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Matteo De Simone, Anis Choucha, Carlotta Ranalli, Giuseppina Pecoraro, Romain Appay, Oliver L Chinot, Henry Dufour, Giorgio Iaconetta
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引用次数: 0

Abstract

IDH-mutant astrocytomas (AIDHmut) in the posterior cranial fossa (PCF) are rare and present substantial diagnostic and therapeutic challenges due to their location. We analyzed patients with PCF AIDHmut from our institutions, treated between December 2021 and September 2024. Additionally, we conducted a systematic literature review (from January 2021 to September 2024) using PubMed, Ovid MEDLINE, and Ovid EMBASE to identify cases of PCF AIDHmut. We identified a total of 19 cases, including one institutional case. Most patients were young adults, with a male predominance (15 males, 4 females). Tumors primarily originated from the brainstem (94.7%), with only one case involving the cerebellum. Clinical presentations frequently included cranial nerve deficits, with diplopia being the most common symptom (47.4%). Adjuvant radiotherapy (IMRT, DT 54 Gy/27 fractions, 78.9%) and chemotherapy (temozolomide, 68.4%) formed the mainstays of treatment. Tumor grading revealed 63.2% (12/19) were WHO grade 2, 21% (4/19) were WHO grade 3, and 15.8% (3/19) were grade 4. The mean follow-up period was 45 months. PCF AIDHmut are rare but pose significant treatment challenges due to their location and infiltrative nature. Multimodal treatment-comprising surgery, radiotherapy, and chemotherapy-is essential for achieving long-term disease control. Subtotal resection followed by adjuvant therapies provides a favorable balance between tumor control and functional preservation.

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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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