Pleomorphic Xanthoastrocytoma with Anaplastic Features in the Tectal Region in a Young Adult Patient: A Case Report

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• 作者：Yuuto Suzuki¹ ; Yukinori Akiyama¹ ; ^{akiyuki@sapmed.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yuusuke Kimura¹ ; Shintaro Sugita² ; Tadashi Hasegawa² ; Nobuhiro Mikuni¹
• 关键词：Anaplastic ; Pleomorphic xanthoastrocytoma ; Tectal
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：94
• 期：Complete
• 页码：580.e11-580.e15
• 全文大小：3779 K

文摘

Pleomorphic xanthoastrocytomas (PXAs) in the tectal region are exceedingly rare and have distinctive clinicopathological features.

Case Presentation

A 17-year-old man was admitted to our hospital owing to headache and diplopia. Magnetic resonance imaging showed a mass lesion in the tectal gland accompanied by obstructive hydrocephalus. A biopsy and third ventriculostomy were performed. Pathological examination revealed a PXA. Total excision of the lesion was achieved via an occipital transtentorial procedure performed 6 weeks after the biopsy. A pathological examination at that time showed a PXA with anaplastic features and a high mitotic index in surgical specimens. The patient's symptoms improved after the second operation, and radiation and temozolomide-based chemotherapy were administered. No recurrence was found at 24 months after the second operation.

Conclusions

Maximum resections are recommended in cases with anaplastic features such as a high mitotic index in biopsy specimens because of the likelihood of recurrence and the low overall survival rate. We administered radiotherapy and temozolomide-based chemotherapy because of the high mitotic activity detected in surgical specimens. The postoperative course in this case is currently deemed acceptable.