Abstract:
:Pleomorphic xanthoastrocytoma (PXA) has been considered an astrocytic tumor with a relatively favorable prognosis. However, PXA cases having several recurrent patterns with poor prognosis have been reported in recent years, and a new concept of anaplastic PXA has been proposed. The present case was a 59-year-old woman who presented with tumor bleeding onset and cerebrospinal fluid dissemination. The patient had sudden-onset right hemiparesis, aphasia, and consciousness disturbance and was admitted to a local area hospital. After emergency surgery had removed the hematoma, postoperative contrast-enhanced CT scan revealed a left temporal tumor. A second surgery was therefore performed for initial tumor removal 2 months later. Histopathological findings showed that the tumor was typical PXA with strong pleomorphism and xanthomatous changes and contained an ependymoma-like component in the center area. However, endothelial proliferation and mitosis were more remarkable compared to ordinary PXA. The MIB-1 labeling index was 9.8% high. From these findings, the histopathological diagnosis was anaplastic PXA. The patient underwent surgery to remove recurrent tumors 5 and 16 months later. The patient died 36 months after the first onset, and CT revealed glioblastoma-like findings and cerebrospinal fluid dissemination. This case report is the first case in which PXA presented with tumor bleeding onset. Histopathological findings suggested anaplastic PXA from the first surgical specimens, and PXA recurred many times. We thus believe that the patient displayed primary anaplastic PXA rather than secondary anaplastic PXA that results in malignant transformation.
journal_name
Brain Tumor Patholjournal_title
Brain tumor pathologyauthors
Asano K,Miyamoto S,Kubo O,Kikkukawa T,Yagihashi A,Ohkuma Hdoi
10.1007/s10014-006-0197-6subject
Has Abstractpub_date
2006-04-01 00:00:00pages
55-63issue
1eissn
1433-7398issn
1861-387Xjournal_volume
23pub_type
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
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pub_type: 杂志文章,评审
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
pub_type: 杂志文章
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更新日期:2004-01-01 00:00:00
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doi:10.1007/s10014-010-0271-y
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pub_type: 杂志文章
doi:10.1007/s10014-012-0098-9
更新日期:2013-01-01 00:00:00
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journal_title:Brain tumor pathology
pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
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journal_title:Brain tumor pathology
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