A Case of Diffuse Multicentric Metachronous Astrocytoma of Temporoinsular and Intramedullary Location

Author Info

Jorge Linares Torres Guillermo Ibanez Botella Antonio Selfa Rodriguez Laura Cerro Larrazabal Julia Casado Ruiz Miguel Angel Arraez Sanchez

Corresponding Author

Jorge Linares Torres
Neurosurgery Department, Regional University Hospital of Malaga, University of Malaga, Malaga, Spain

A B S T R A C T

Multiple gliomas are rare glial tumors with a histology that is typically consistent with high-grade gliomas. A distinction is made between multifocal and multicentric gliomas according to criteria of anatomical continuity, as well as between synchronous and metachronous gliomas according to chronological time of onset. We present the case of a professional saxophonist with a left temporoinsular lesion who underwent awake craniotomy with monitoring of verbal and musical ability as well as primary sensory and motor cortices. Histopathological study revealed an isocitrate dehydrogenase 1 (IDH)-mutant diffuse astrocytoma. After 4 years of complete oncological remission, the patient developed impaired proprioception in all four extremities. An intramedullary lesion was detected at the level of C4 consistent with an IDH wild-type diffuse astrocytoma. We highlight the singularity of this case as it involved two low-grade glial lesions, separated in time (metachronous) and location (multicentric), as well as genetic differences between both lesions (IDH mutant and wild type).

Article Info

Article Type

Case Report

Publication history

Received: Thu 28, Jan 2021
Accepted: Mon 23, Aug 2021
Published: Mon 30, Aug 2021

Copyright

© 2023 Jorge Linares Torres. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSCR.2021.01.02