Skip to main content

Advertisement

SpringerLink
Log in

Superficial siderosis in long-standing pilocytic astrocytoma

  • Brief Communication
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Background

Pilocytic astrocytoma (PA) rarely spreads along neuraxis, and association with superficial siderosis (SS) and chronic signs of intracranial hypertension is exceptional.

Case report

A 48-year-old woman presented with slow onset hearing loss in the past year. Clinical examination revealed dysarthria, positive Romberg test, and severe optic neuropathy. Cerebrospinal fluid (CSF) analysis showed numerous red blood cells, increased proteins and LDH, and high opening pressure. Brain and spine MRI demonstrated extensive superficial siderosis, bone remodeling of the skull base and spine, and diffuse nodular leptomeningeal enhancement. Histological examination of a nodule in the dorsal spine evidenced PA.

Conclusion

We report a case of PA associated with dural remodeling and SS. The mechanism of SS is unclear but might be related to meningeal tumor infiltration and altered CSF composition and resorption.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Mazloom A, Hodges JC, Teh BS et al (2012) Outcome of patients with pilocytic astrocytoma and leptomeningeal dissemination. Int J Radiat Oncol Biol Phys 84:350–354. https://doi.org/10.1016/j.ijrobp.2011.12.044

    Article  PubMed  Google Scholar 

  2. White JB, Piepgras DG, Scheithauer BW, Parisi JE (2008) Rate of spontaneous hemorrhage in histologically proven cases of pilocytic astrocytoma. J Neurosurg 108:223–226. https://doi.org/10.3171/JNS/2008/108/2/0223

    Article  PubMed  Google Scholar 

  3. Levy M, Turtzo C, Llinas RH (2007) Superficial siderosis: a case report and review of the literature. Nat Clin Pract Neurol 3:54–58. https://doi.org/10.1038/ncpneuro0356

    Article  PubMed  Google Scholar 

  4. Kumar N (2012) Beyond superficial siderosis: introducing “duropathies.” Neurology 78:1992–1999. https://doi.org/10.1212/WNL.0b013e318259e272

    Article  PubMed  Google Scholar 

  5. Kumar N (2021) Superficial siderosis: a clinical review. Ann Neurol 89:1068–1079. https://doi.org/10.1002/ana.26083

    Article  PubMed  Google Scholar 

  6. Wilson D, Chatterjee F, Farmer SF et al (2017) Infratentorial superficial siderosis: classification, diagnostic criteria, and rational investigation pathway. Ann Neurol 81:333–343. https://doi.org/10.1002/ana.24850

    Article  CAS  PubMed  Google Scholar 

  7. McCarron MO, McKinstry CS, Gibson JM (2002) Superficial siderosis 20 years after brain tumour. Lancet Neurol 1:326. https://doi.org/10.1016/S1474-4422(02)00138-2

    Article  PubMed  Google Scholar 

  8. Yoshiki K, Sasagawa Y, Kinoshita M et al (2020) Superficial siderosis associated with long-term recurrence of pilocytic astrocytoma in an elderly person. World Neurosurg 138:541-544.e1. https://doi.org/10.1016/j.wneu.2020.03.112

    Article  PubMed  Google Scholar 

  9. Bostantjopoulou S, Katsarou Z, Pigadas A, Kazis A (2000) Superficial CNS siderosis and spinal pilocytic astrocytoma. Neurology 55:450. https://doi.org/10.1212/WNL.55.3.450

    Article  CAS  PubMed  Google Scholar 

  10. Farb RI, Nicholson PJ, Peng PW et al (2019) Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography. Am J Neuroradiol 40:745–753. https://doi.org/10.3174/ajnr.A6016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neuroradiology Unit, Department of Technology and Diagnosis, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, Milan, Italy

    Alessandra Erbetta, Filippo Savoldi & Luisa Chiapparini

  2. Diagnostic Radiology and Interventional Neuroradiology Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Valentina Opancina & Elisa F. M. Ciceri

  3. Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    Valentina Opancina

  4. Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Gianluca Marucci

  5. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Marco Schiariti

  6. Clinical Neurology Unit, Department of Clinical Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Veronica Redaelli

Authors
  1. Alessandra Erbetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Filippo Savoldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Valentina Opancina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gianluca Marucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marco Schiariti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Veronica Redaelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elisa F. M. Ciceri
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Luisa Chiapparini
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AE, EC, and LC: conceptualization, data curation, supervision, writing—original draft preparation, writing—editing; FS, VO, MS, VR: data curation, writing—editing; GM data curation, supervision.

Corresponding author

Correspondence to Filippo Savoldi.

Ethics declarations

Informed consent

Informed written consent was obtained from the patient.

Conflict of interest

The authors declare no competing interests.

Ethical approval

All material has been collected and handled with rigorous ethical standards. A formal approval from the IRB has been waived for case reports.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Erbetta, A., Savoldi, F., Opancina, V. et al. Superficial siderosis in long-standing pilocytic astrocytoma. Neurol Sci 43, 4559–4561 (2022). https://doi.org/10.1007/s10072-022-06077-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-022-06077-w

Keywords

Search

Navigation