Low-grade gliomas and leptomeningeal dissemination: a poorly understood phenomenon
- 5 April 2003
- journal article
- review article
- Published by Springer Science and Business Media LLC in Child's Nervous System
- Vol. 19 (4), 197-203
- https://doi.org/10.1007/s00381-003-0733-1
Abstract
The leptomeningeal dissemination (LMD) of low-grade gliomas (LGGs) is reported in clinical neuro-oncology practice more and more frequently. It is estimated that 5% of all childhood LGGs present LMD at diagnosis and 7-10% at the time of progression. LMD has been reported in association with almost all the known subtypes of LGGs. Furthermore, "unusual " LGGs can be encountered among slow-growing brain neoplasm capable of LMD, which cannot comfortably be included in the present WHO brain tumour classification. The biological, genetic and clinical characteristics that seem to favour LMD are far from being understood. Similarly, the clinical profile of those children with disseminated LGGs has not yet been firmly established. Young, non-neurofibromatosis type 1 boys with large hypothalamic-chiasmatic pilocytic astrocytomas seem to be at increased risk of LMD. The neuroradiological appearance of LMD in childhood LGGs is similar to that observed in malignant tumours, except for those cases characterised by multiple superficial non-enhancing cystic lesions, which seem to be almost exclusively associated with a type of slow-growing not yet fully identified brain stem or spinal tumour. No firm guidelines for the treatment of these diseases are yet available, mostly due to the rarity of this condition and the existing uncertainties regarding their natural clinical history. The evidence of LMD in children with LGGs does not seem to have a negative impact on patients' long-term outcome.This publication has 32 references indexed in Scilit:
- Leptomeningeal dissemination in children with progressive low-grade neuroepithelial tumorsNeuro-Oncology, 2002
- Fatal pleomorphic xanthoastrocytoma with meningeal gliomatosisHistopathology, 1998
- Successful treatment of childhood pilocytic astrocytomas metastatic to the leptomeninges with high-dose CyclophosphamideMedical and Pediatric Oncology, 1996
- Low-grade astrocytoma with neuraxis dissemination at diagnosisJournal of Neurosurgery, 1995
- Multiple intraspinal low-grade astrocytomas mixed with lipoma (astrolipoma)Journal of Neurosurgery, 1995
- Treatment options and prognosis for multicentric juvenile pilocytic astrocytomaJournal of Neurosurgery, 1994
- Low-Grade Astrocytoma of the Tectal Region as an Unusual Cause of Knee Pain: Case ReportNeurosurgery, 1991
- Low-grade astrocytoma of the tectal region as an unusual cause of knee painNeurosurgery, 1991
- The risks of metastases from shunting in children with primary central nervous system tumorsJournal of Neurosurgery, 1991
- Spinal metastasis of pilocytic astrocytoma of the chiasma opticumChild's Nervous System, 1989