This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Etzl, M. M. Articles by Bandy, D. J. Search for Related Content PubMed PubMed Citation Articles by Etzl, M. M., JR Articles by Bandy, D. J. Social Bookmarking                   What's this?

Positron Emission Tomography in Three Children With Pleomorphic Xanthoastrocytoma

Divisions of Hematology/Oncology, Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Phoenix, Arizona

Allen M. Kaplan, MD

Division of Child Neurology, Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Poenix, Arizona, Division of Pediatric Neurology University of Arizona, Tucson, Arizona

S. David Moss, MD

Division of Neurosurgery, Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Poenix, Arizona

Joseph Spataro, MD

Division of Neuropathology, Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Poenix, Arizona

Charles T. Bonstelle, MD

Division of Radiology, Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Phoenix, Arizona

Michael A. Lawson, MD

Positron Emission Tomography Center at Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Phoenix, Arizona

Daniel J. Bandy, MS

Positron Emission Tomography Center at Phoenix Children's Hospital/Good Samaritan Regional Medical Center, Phoenix, Arizona

The pleomorphic xanthoastrocytoma is generally considered a low-grade neoplasm with favorable prognosis. These tumors, however, can demonstrate primary anaplastic features, undergo malignant transformation, disseminate, or progress with poor outcome. Currently, there are no histologic or clinical features that reliably predict recurrent tumor or tumor progression. We report three children with confirmed pleomorphic xanthoastrocytoma who were studied with positron emission tomography (PET) using [¹⁸F]fluorodeoxyglucose (FDG) coregistered with magnetic resonance imaging. One patient had decreased FDG metabolism and, despite a gross total resection and benign pathology, had early local recurrence. Subsequent to a second surgical resection and radiation therapy, he has remained stable for 8 years. One patient with significant FDG uptake had gross total resection of an anaplastic pleomorphic xanthoastrocytoma. Follow-up FDG studies showed no abnormal metabolic activity, and he has been stable without adjuvant treatment for 5 years. The last patient had intermediate FDG uptake and a moderate-grade pleomorphic xanthoastrocytoma by histopathology. She showed early tumor progression with spinal metastases. Following a near-total resection of the recurrent intracranial lesion and neuroaxis radiation, she has been stable for 4 years. Although there are still no reliable prognostic indicators for pleomorphic xanthoastrocytoma, PET with FDG correlates with histopathology, and increased uptake may be a marker for more malignant or aggressive tumors. The extent of surgical resection in regard to prognosis in our limited study is unclear but appears helpful in the anaplastic pleomorphic xanthoastrocytoma case. Adjuvant radiation therapy also may benefit certain patients. Further PET studies are warranted in this group of tumors. (J Child Neurol 2002;17:522-527).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?