Superficial cerebral astrocytoma attached to dura: Report of six cases in infants

Reported are six cases of meningocerebral astrocytomas attached to dura, involving the superficial cortex, in infants under 1 year of age. They represent 1.25% of 483 intracranial tumors in infancy studied at the Children's Hospital in the last 12 years. Five were located in the frontal lobes, with variable extension to the parietal or the parietotemporal regions, and one was located in the parietal lobe. They were all composed of a solid portion and one or more cysts, and they measured approximately 6 to 12 cm in diameter. They had spindle cells, some more plump, arranged in areas in a storiform pattern. Tumors were very rich in reticulin fibers, mimicking a mesenchymal tumor. There was very slight pleomorphism. Bizarre giant cells were not observed and lipidization was not a prominent feature. Immunoperoxidase technique was performed in all of them and showed glial fibrillary acidic protein (GFAP) in most of the tumor cells. We believe their origin is from subpial astrocytes. They probably represent a separate entity whose diagnosis cannot be accurately established without immunohistochemical techniques.