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Case Reports
. 2016 Jul-Sep;11(3):319.
doi: 10.4103/1793-5482.144161.

Pleomorphic xanthoastrocytoma with anaplastic features: A rare case report and review of literature with reference to current management

M R Patibandla  1 , Madhukar Nayak  1 , A K Purohit  1 , Amit Kumar Thotakura  2 , Megha Uppin  3 , Sundaram Challa  3
Affiliations
Case Reports

Pleomorphic xanthoastrocytoma with anaplastic features: A rare case report and review of literature with reference to current management

M R Patibandla et al. Asian J Neurosurg. 2016 Jul-Sep.

Abstract

Pleomorphic xanthoastrocytoma (PXA) is an uncommon tumor constitutes less than 1% of all astrocytic glial neoplasms was first reported in 1979. PXA commonly occurs in young patients and manifests itself first as seizures followed by focal neurological deficits. The role of radiotherapy or chemotherapy has not yet been established because of the relative infrequency of this disease. PXA is classified as grade II tumor in the WHO classification of tumors of the CNS. In literature 9 to 20 % PXA may undergo malignant change at recurrence or may display at the time of initial presentation. Malignant transformation is mainly associated with high mitotic activity and necrosis. The criteria for PXA with anaplastic features was five or more mitotic activity per 10 high power fields, necrosis, microvascular proliferation, marked cellular anaplasia, and high Ki-67 labeling indices. PXA with anaplastic features management is highly controversial as very sparse literature is available. We are reporting a case of PXA with anaplastic features with atypical radiology and tried to review the up to date literature regarding this rare tumor.

Keywords: PXA with anaplasia; Pleomorphic xanthoastrocytoma; astrocytoma; management of PXA.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
CT scan of brain (plain) showing hypodensity with surrounding edema and MRI of brain (plain) and contrast showing a heterogenous intensely enhancing right frontal mass lesion which is crossing to opposite hemisphere through corpus callosum with perilesional edema which is hypo on T1W and hyper intense on T2 W
Figure 2
Figure 2
Histopathology of the pleomorphic xanthoastrocytoma with anaplastic features showing arrow eosinophilic granular bodies (a) ×100, arrow showing pleomorphic giant cells; (b) ×400, arrow showing mitoses; (c) ×400, IHC showing CD 68 negative and GFAP positive
See this image and copyright information in PMC

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