Highlights
- •Infratentorial PXAs may follow the conventional imaging characteristics of those located in the supratentorial compartment
- •Advanced MRI features of infratentorial PXAs follow the same rules for grade discrimination used in other astrocytic tumors
- •Infratentorial non-restricting periventricular solid-cystic lesion in a young patient should raise suspicion for PXA
Abstract
Pleomorphic xanthoastrocytoma (PXA) is a rare glioma usually occurring in children
and young adults. It is a benign World Health Organization (WHO) grade II tumor that
accounts for <1% of all astrocytomas. Its occurrence in the infratentorial compartment
is rare, and the cerebellum is the most common of the unusual locations. Few case
reports have described conventional imaging features of these tumors, but none has
reported the advanced magnetic resonance (MR) neuroimaging features in dynamic susceptibility
perfusion-weighted imaging (DSC-PWI), diffusion weighted-imaging (DWI) and MR spectroscopy.
Therefore, the purpose of this study is to report a case of PXA in the cerebellum
of a 28-year-old patient and discuss the MR advanced imaging characteristics compared
to the more common PXA supratentorial type.
Abbreviations:
PXA (pleomorphic xanthoastrocytoma), DSC-PWI (dynamic susceptibility perfusion-weighted imaging), DWI (diffusion weighted-imaging), MRI (magnetic resonance imaging), CT (Computed tomography), WHO (World Health Organization), FLAIR (Fluid attenuation inversion recovery), NAA (N-acetylaspartate), ADC (apparent diffusion coefficient), GFAP (Glial fibrillary acidic protein), CBV (cerebral blood volume), IDH1 (isocitrate dehydrogenase 1)Keywords
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References
- Pleomorphic xanthoastrocytoma: what do we really know about it?.Cancer. 1999; 85: 2033-2045
- Pleomorphic xanthoastrocytoma: a distinctive meningocerebral glioma of young subjects with relatively favorable prognosis. A study of 12 cases.Cancer. 1979; 44: 1839-1852
- An infratentorial pure pleomorphic xanthoastrocytoma arising from middle cerebellar peduncle: a rare location of an uncommon tumor.World Neurosurg. 2018; 111: 335-340
- MR imaging features of anaplastic pleomorphic xanthoastrocytoma mimicking high-grade astrocytoma.AJNR Am. J. Neuroradiol. 2018; 39: 1446-1452
- A 15 year old boy with a posterior fossa tumor.Brain Pathol. 2009; 19: 349-352
- Pleomorphic xanthoastrocytoma: magnetic resonance imaging findings in a series of cases with histopathological confirmation.Arq. Neuropsiquiatr. 2013; 71: 35-39
- Pleomorphic xanthoastrocytoma: clinical, imaging and pathological features of four cases.Clin. Neurol. Neurosurg. 1997; 99: 40-45
- Pleomorphic xanthoastrocytoma: MR imaging findings in 19 patients.Acta Radiol. 2011; 52: 223-228
- Cerebellar pleomorphic xanthoastrocytoma: case report and literature review.Surg. Neurol. 2007; 68 (discussion -5): 89-94
- Cerebellar pleomorphic xanthoastrocytoma: case report.Neurosurgery. 1994; 35 ([discussion 50-1]): 947-950
- Composite pleomorphic xanthoastrocytoma and ganglioglioma: report of four cases and review of the literature.Am. J. Surg. Pathol. 1997; 21: 763-771
- Cerebellar pleomorphic xanthoastrocytoma in an infant.Pathol. Int. 1999; 49: 811-815
- Multicentric pleomorphic xanthoastrocytoma in a patient with neurofibromatosis type 1. Case report and review of the literature.J. Neurosurg. 2005; 102: 376-381
- Pediatric cerebellar pleomorphic xanthoastrocytoma with anaplastic features: a case of long-term survival after multimodality therapy.Childs Nerv. Syst. 2006; 22: 609-613
- Pleomorphic xanthoastrocytoma of the cerebellopontine angle in a child.Childs Nerv. Syst. 2006; 22: 1479-1482
- A case report of cerebellar pleomorphic xanthoastrocytoma.No Shinkei Geka. 2009; 37: 586-590
- A 16-year-old male with a cerebellar mass.Brain Pathol. 2009; 19: 167-170
- A 14-year-old girl with multiple tumors.Brain Pathol. 2012; 22: 865-868
- Atypical teratoid/rhabdoid tumor arising in pleomorphic xanthoastrocytoma: a case report.Neuropathology. 2014; 34: 398-405
- Cerebellar pleomorphic xanthoastrocytoma in a patient with neurofibromatosis type 1: a case report and literature review.Int. J. Clin. Exp. Pathol. 2015; 8: 7570-7574
- Peritumoral edema affects the prognosis in adult pleomorphic xanthoastrocytoma: retrospective analysis of 25 patients.World Neurosurg. 2018; 114 (e457-e67)
- Proton MR spectroscopic characteristics of pediatric pilocytic astrocytomas.AJNR Am. J. Neuroradiol. 1998; 19: 535-540
- Diagnostic accuracy of diffusion weighted imaging for differentiation of supratentorial pilocytic astrocytoma and pleomorphic xanthoastrocytoma.Neuroradiology. 2018; 60: 725-733
- Immunophenotype of pleomorphic xanthoastrocytoma.Am. J. Surg. Pathol. 2002; 26: 479-485
- Giant cell glioblastoma and pleomorphic xanthoastrocytoma show different immunohistochemical profiles for neuronal antigens and p53 but share reactivity for class III beta-tubulin.Arch. Pathol. Lab. Med. 2003; 127: 1187-1191
- Pleomorphic xanthoastrocytoma: natural history and long-term follow-up.Brain Pathol. 2015; 25: 575-586
- Impact of WHO 2016 update of brain tumor classification, molecular markers and clinical outcomes in pleomorphic xanthoastrocytoma.J. Neuro-Oncol. 2018; 136: 343-350
- Pleomorphic xanthoastrocytoma: favorable outcome after complete surgical resection.Neuro-oncology. 2001; 3: 184-192
- Malignant transformation of pleomorphic xanthoastrocytoma.in: SpringerLink. 2019
- Pleomorphic xanthoastrocytoma: a developmental glioneuronal tumor with prominent glioproliferative changes.J. Neuro-Oncol. 2004; 66: 17-27
Article info
Publication history
Published online: February 25, 2020
Accepted:
February 24,
2020
Received in revised form:
January 30,
2020
Received:
November 6,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
