Pediatric diffuse intrinsic anaplastic astrocytoma of the medulla oblongata

Abstract

Focal tumors of the brain stem are classically low grade astrocytomas. We present the rare case of a child with an anaplastic astrocytoma confined to the medulla oblongata. An 11-year-old male found to have an intrinsic tumor of the medulla oblongata; the initial MRI was equivocal for determining the focal or diffuse nature of the tumor. After a subtotal resection followed by aggressive adjuvant therapy, rapid deterioration and death occurred at 16 months after initial diagnosis and surgery. Diffuse intrinsic anaplastic astrocytomas confined to the medulla oblongata are extremely rare. Diffuse tension imaging, a short period of symptoms, and presence of cranial nerve deficits are suggestive of a malignant histopathology. Prognosis is poor.