Brain-Stem Gliomas:Growth Patterns, Pathology, and Prognosis.
- Author:
Young Shin RA
1
;
C Jin WHANG
Author Information
1. Department of Neurological Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Brain-stem tumor;
Prognosis;
Pathology;
Glioma;
Magnetic resonance imaging
- MeSH:
Astrocytoma;
Cranial Nerve Diseases;
Cranial Nerves;
Diagnosis;
Glioblastoma;
Glioma;
Humans;
Hydrocephalus;
Magnetic Resonance Imaging;
Pathology*;
Prognosis*;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
1995;24(12):1537-1547
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A retrospective study of 29 cases of brain-stem gliomas(BSG's) from 1989 to 1993, was performed to determine prognostic factors. Our study also analyzed clinical features, growth patterns, pathologic findings and modalities of treatment in patients with brain-stem gliomas. The patients ranged in age from 6 to 65 years, most commonly in the first decade. The symptom duration prior to diagnosis was 1/2 to 6 months(mean 1 1/2 months). The most common symptom and sign were cranial nerve palsies, especially 6th or 7th cranial nerve. The growth patterns of BSG's were classified into diffuse tumors(7 patients), exophytic(9 patients), focal(2 patients) and cervicomedullary(1 patient). Twenty three of 29 patients were diagnosed pathologically by means of stereotactic biopsy(13 patients) and ope surgery(10 patients). The Pathologic findings were low grade astrocytoma in 9 patients, oligodendroglioma(3 patients), malignant astrocytoma(7 patients), and glioblastoma mulitiforme(4 patients). A significant correlation between diffuse growth pattern and malignant pathologic finding could be obtained(P=0.05). The methods of radiation therapy for BSG's were conventional(10 patients), hyperfractionated(13 patients), and Gamma knife radiosurgery(6 patients). The median survival time was 12 months. The Poor prognostic factors determined in our study were 1) short symptom duration prior to diagnosis(< or = 2 months), 2) diffuse growth pattern, 3) malignant pathologic finding, 4) tumor without cystic portion, and 5) tumor without hydrocephalus.
