Pleomorphic xanthoastrocytoma, case series and review of literature
Abstract Background Pleomorphic xanthoastrocytoma is a rare circumscribed astrocytic glial neoplasm that represents less than 1% of astrocytic tumors. This is a retrospective descriptive hospital-based study of this rare tumor that includes five patients. Epidemiologic characteristics and preoperati...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-02-01
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| Series: | Egyptian Journal of Neurosurgery |
| Online Access: | https://doi.org/10.1186/s41984-025-00382-0 |
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| author | Farrag Mohammad Ahmed Abd Essattar Abd Elhakeem Ahmad Algheriany Ahmed Elshanawany |
| author_facet | Farrag Mohammad Ahmed Abd Essattar Abd Elhakeem Ahmad Algheriany Ahmed Elshanawany |
| author_sort | Farrag Mohammad |
| collection | DOAJ |
| description | Abstract Background Pleomorphic xanthoastrocytoma is a rare circumscribed astrocytic glial neoplasm that represents less than 1% of astrocytic tumors. This is a retrospective descriptive hospital-based study of this rare tumor that includes five patients. Epidemiologic characteristics and preoperative clinical findings were recorded. Preoperative MRI characteristics and postoperative histopathology and immunohistochemistry were analyzed. Results The study included five patients, two diagnosed as Pleomorphic xanthoastrocytoma grade 2 tumors and three patients diagnosed as Pleomorphic xanthoastrocytoma grade 3 tumors. Age ranged from 4 to 47 years, three females and two males. All cases presented with seizures, only one case showed neurological deficit. The solid portions showed hyperintense signal in diffusion-weighted image in three cases (Pleomorphic xanthoastrocytoma grade 3), while two cases showed isointense signal (Pleomorphic xanthoastrocytoma grade 2). The mean apparent diffusion coefficient was 0.76 × 10–3 mm2/sec and 1.005 × 10–3 mm2/sec, respectively. Regarding immunohistochemistry, cytoplasmic glial fibrillary acidic protein was strongly positive in all five cases as well as synaptophysin. IDH was negative in all cases. CD34 was positive in three cases, P53 was positive in three cases (Pleomorphic xanthoastrocytoma grade 3), Ki67 was positive in three cases (Pleomorphic xanthoastrocytoma grade 3). Conclusion Pleomorphic xanthoastrocytomas are rare neoplasms with a better prognosis in grade 2 than grade 3. Diffusion-weighted imaging technology can be used to differentiate between grade 2 and grade 3 Pleomorphic xanthoastrocytoma preoperatively but further studies on larger samples are needed to confirm the possibility. Mitotic count is the main parameter used to differentiate Pleomorphic xanthoastrocytoma grade 2 and grade 3, but immunohistochemistry can play a role in that in the future. |
| format | Article |
| id | doaj-art-73115e422ab74074ac611ee95e8c1c8d |
| institution | Kabale University |
| issn | 2520-8225 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Neurosurgery |
| spelling | doaj-art-73115e422ab74074ac611ee95e8c1c8d2025-02-02T12:12:48ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252025-02-014011910.1186/s41984-025-00382-0Pleomorphic xanthoastrocytoma, case series and review of literatureFarrag Mohammad0Ahmed Abd Essattar Abd Elhakeem1Ahmad Algheriany2Ahmed Elshanawany3Department of Neurosurgery, Faculty of Medicine, Assiut UniversityDepartment of Pathology, Faculty of Medicine, Al-Azhar UniversityDepartment of Neurosurgery, Faculty of Medicine, Assiut UniversityDepartment of Neurosurgery, Faculty of Medicine, Assiut UniversityAbstract Background Pleomorphic xanthoastrocytoma is a rare circumscribed astrocytic glial neoplasm that represents less than 1% of astrocytic tumors. This is a retrospective descriptive hospital-based study of this rare tumor that includes five patients. Epidemiologic characteristics and preoperative clinical findings were recorded. Preoperative MRI characteristics and postoperative histopathology and immunohistochemistry were analyzed. Results The study included five patients, two diagnosed as Pleomorphic xanthoastrocytoma grade 2 tumors and three patients diagnosed as Pleomorphic xanthoastrocytoma grade 3 tumors. Age ranged from 4 to 47 years, three females and two males. All cases presented with seizures, only one case showed neurological deficit. The solid portions showed hyperintense signal in diffusion-weighted image in three cases (Pleomorphic xanthoastrocytoma grade 3), while two cases showed isointense signal (Pleomorphic xanthoastrocytoma grade 2). The mean apparent diffusion coefficient was 0.76 × 10–3 mm2/sec and 1.005 × 10–3 mm2/sec, respectively. Regarding immunohistochemistry, cytoplasmic glial fibrillary acidic protein was strongly positive in all five cases as well as synaptophysin. IDH was negative in all cases. CD34 was positive in three cases, P53 was positive in three cases (Pleomorphic xanthoastrocytoma grade 3), Ki67 was positive in three cases (Pleomorphic xanthoastrocytoma grade 3). Conclusion Pleomorphic xanthoastrocytomas are rare neoplasms with a better prognosis in grade 2 than grade 3. Diffusion-weighted imaging technology can be used to differentiate between grade 2 and grade 3 Pleomorphic xanthoastrocytoma preoperatively but further studies on larger samples are needed to confirm the possibility. Mitotic count is the main parameter used to differentiate Pleomorphic xanthoastrocytoma grade 2 and grade 3, but immunohistochemistry can play a role in that in the future.https://doi.org/10.1186/s41984-025-00382-0 |
| spellingShingle | Farrag Mohammad Ahmed Abd Essattar Abd Elhakeem Ahmad Algheriany Ahmed Elshanawany Pleomorphic xanthoastrocytoma, case series and review of literature Egyptian Journal of Neurosurgery |
| title | Pleomorphic xanthoastrocytoma, case series and review of literature |
| title_full | Pleomorphic xanthoastrocytoma, case series and review of literature |
| title_fullStr | Pleomorphic xanthoastrocytoma, case series and review of literature |
| title_full_unstemmed | Pleomorphic xanthoastrocytoma, case series and review of literature |
| title_short | Pleomorphic xanthoastrocytoma, case series and review of literature |
| title_sort | pleomorphic xanthoastrocytoma case series and review of literature |
| url | https://doi.org/10.1186/s41984-025-00382-0 |
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