Malignant transformation in benign cerebellar astrocytoma

Authors:
  • GKGeorge M. Kleinman
    George M. Kleinman
  • WSWilliam C. Schoene
    William C. Schoene
  • TWThomas M. Walshe
    Thomas M. Walshe
  • EREdward P. Richardson
    Edward P. Richardson
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Abstract
Follow-up information on case 59 of Cushing''s 1931 series of cerebellar astrocytomas was presented. The patient died with a malignant cerebellar astrocytoma 48 yr after partial removal of a previously benign astrocytoma at the same site. Including the present one, there were only 5 reported cases in which this occurred. Juvenile pilocytic astrocytomas are of extremely benign character, and even with incomplete resections patients have survived for years without progression of the tumor. Not all cases so reported can be wholly accepted as representing malignant transformation of the tumor, but may instead be instances of recurrence of an inherently benign glioma since the presence of features such as endothelial hyperplasia or nuclear atypicality in a juvenile pilocytic astrocytoma does not warrant its being classified as malignant. Features truly suggestive of malignancy are hypercellularity, frequent mitoses, necrosis, and, in some instances, a diffusely infiltrative growth pattern. All of these features were found in the present case.

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