A case of Pleomorphic xanthoastrocytoma

Background: Pleomorphic xantho astrocytoma.(PXA) Is Astrocytic neoplasm( WHO grade II) with relatively favorable prognosis .It typically occurs in children and youngadults but older patients may be affected w ithout gender predilection.98% arise supratentorially, with preferential temporal lobe involvement associated with intractableseizure and 15 - 20% progress to malignancy. No necrosis and no mitotic activity is seen.Lesions with significant mitotic activity (5+ mitoses per 10 HPF) or with areas ofnecrosis may be designated pleomorphic xanthoastrocytoma with anaplastic features . Case report: Our case is a 14-year-old girl who complains of episodic seizures for a fewmonths. He had no significant family history of seizures or other neurologic disorders. No hazard exposure , medication , or head trauma Systemic physical examination wasunremarkableNeurologic and neuroradiologic examinations revealed a right temporal lobe lesion. Brain CT Scan showed, heterodense solid cystic lesion at right temporal lobe candue to low grade astrocytoma or DNET .pathologic examination was performed .Grossly it was a round well defined creamy mass m(3.5*2*1cm) with focally hemorrhagic.area.Microscopically show brain tissue with a malignant growth composed of polymorphic astrocytic cells with nuclear inclusion and cytoplasmic xanthomatous change.spindle cells arranged in fasicular pattern .perivascular lymphocytic cuffing ,eosinophilic granular bodies are other findings.IHC was done, GFAP was Positive . ,CD34,chromogranin and ,cynaptophisin were Negative.Ki67 in 2% of tumoral cells was positive. Reticulin stain was positive Conclusion: PXA is rare and presents with seizure;low risk of recurrence and should be differ from anaplastic astrocytoma because of prognosis

Keywords:

Pleomorphic xanthoastrocytoma , seizure , anaplastic astrocytoma