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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(01): 223-227
DOI: 10.1055/s-0043-1764325
Case Report

Low-Grade Astrocytoma Causing Dural and Calvarial Destruction

Hatim Belfquih
1   Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Cadi Ayyad University, Marrakech, Morocco
2   Department of Neurosurgery, Mohammed V. University, Rabat, Morocco
,
Badr Slioui
3   Department of Radiology, Avicenne Military Hospital of Marrakech, Cadi Ayyad University, Marrakech, Morocco
,
Mohamed Amine Azami 
4   Department of Pathology, Avicenne Military Hospital of Marrakech, Cadi Ayyad University, Marrakech, Morocco
,
Ali Akhaddar
1   Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Cadi Ayyad University, Marrakech, Morocco
2   Department of Neurosurgery, Mohammed V. University, Rabat, Morocco
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Abstract

Most of the literature on intra-axial lesions causing calvarial and dural destruction comes from case reports for glioblastoma, lymphoma, metastasis, and aggressive meningioma. Destruction of dura and calvaria by low-grade gliomas is extremely uncommon; cases reported so far have been mostly oligodendrogliomas. This article describes the unusual case of a 23-year-old male patient with a left-sided intra and extracranial tumor involving the frontal lobe, destroying the overlying dura and calvaria, who underwent maximal safe resection. Histopathology showed the tumor to be a low-grade astrocytoma. The calvarial thinning or remodeling caused by low-grade gliomas is thought to result from their chronic mass effect, by displacing the overlying layer of cerebrospinal fluid and transmitting brain pulsations directly to the inner table of the skull. Pressure thinning of the inner table of the skull may be caused by Pacchionian granulations close to the midline. Although this is extremely uncommon, magnetic resonance imaging may include low-grade astrocytoma in the differential diagnosis in such cases.

Keywords

low-grade astrocytoma - dural destruction - calvarial destruction - magnetic resonance imaging - surgical excision

Authors' Contributions

HB contributed to the conception, drafting, reporting of the cases and acquired the clinical data. AA contributed to the revision of the manuscript. All authors have read and approved the final manuscript.


Data Availability

All data generated and analyzed in this study are included in this article.


Informed Consent

The patient provided written informed consent for publication of patient clinical details and clinical images.




Publication History

Article published online:
31 March 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Woodruff Jr WW, Djang WT, Voorhees D, Heinz ER. Calvarial destruction: an unusual manifestation of glioblastoma multiforme. AJNR Am J Neuroradiol 1988; 9 (02) 388-389
    PubMedGoogle Scholar
  • 2 Khan MA, Hashmi S. Low-grade astrocytoma causing calvarial scalloping. Pediatr Neurosurg 2007; 43 (02) 155-157
    CrossrefPubMedGoogle Scholar
  • 3 Lee YY, Van Tassel P. Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AJR Am J Roentgenol 1989; 152 (02) 361-369
    CrossrefPubMedGoogle Scholar
  • 4 Muzumdar DP, Goel A, Pakhmode CK. Oligodendroglioma causing calvarial erosion. Neurol India 2003; 51 (01) 129-130
    PubMedGoogle Scholar
  • 5 Osborn RE, Ley CE. Astrocytoma with calvarial erosion. AJNR Am J Neuroradiol 1986; 7 (01) 178
    PubMedGoogle Scholar
  • 6 Handzhiev DD, Kalevski SK, Handzhieva SV, Dzhenkov DL, Salieva-Badi S. Low grade astrocytoma causing dural and calvarial destruction. J Clin Neurosci 2017; 40: 84-89
    CrossrefPubMedGoogle Scholar
  • 7 Lee JH, Sung SK, Choi CH. Supratentorial pilocytic astrocytoma mimicking convexity meningioma with early anaplastic transformation: a case report. Brain Tumor Res Treat 2017; 5 (02) 105-109
    CrossrefPubMedGoogle Scholar