A rare, pediatric, fourth-ventricular, anaplastic astrocytoma

Abstract

Anaplastic astrocytoma, a diffusely infiltrating, malignant, astrocytic, primary brain tumor, is most commonly observed between 30 and 50 years of age. Anaplastic astrocytomas are now classified as WHO grade III lesions, with imaging characteristics and prognosis between diffuse low-grade astrocytomas (WHO grade II) and glioblastomas (WHO IV). Anaplastic astrocytoma can appear mostly in the cerebrum followed by cerebellum. However, it is rarely observed in the fourth ventricle. In this article, we aimed to describe an uncommon case of a pediatric, fourth-ventricular, anaplastic astrocytoma. A 9-year-old male who underwent MRI brain then adopted gross-total tumor eradication. The final histopathology findings were consistent with an anaplastic astrocytoma.

Keywords: Anaplastic astrocytoma; Children; Extraparenchymal; Intraventricular.

Fig. 1

A homogeneous, high-signal-intensity mass, located in the fourth ventricle, on axial T2-weighted.

Fig. 2

A homogeneous, high-signal-intensity mass, located in the fourth ventricle, on coronal FLAIR imaging.

Fig. 3

No hemosiderin or ossification indicators were observed within the mass on susceptibility-weighted imaging.

Fig. 4

Axial ADC map of the lesion and the cerebellar parenchyma.

Fig. 5

Axial T1-weighted imaging, with contrast enhancement.

Fig. 6

Histopathological sections showed the predominant infiltration of small astrocytic glial cells, with elongated nuclei and nuclear atypia, accompanied by glassy eosinophilic cytoplasm and increased mitotic activity (Hematoxylin and eosin staining, × 100).