One Case Report About Pleomorphic Xanthoastrocytoma And Literatures Review

Objectives: Pleomorphic xanthoastrocytoma(PXA) is a rare tumor of central nervous system. It has special clinical performances, imaging manifestations, pathology, treatment and prognosis. In this article, we reported a special case of pleomorphic xanthoastrocytoma treated in Qilu hospital. And we review 90 cases of PXA, which have been reported since 1979. The aim is to know more about PXA in later clinical practice.Methods: A retrospective study was performed in 90 cases of PXA including one patient treated recently in Qilu hospital. We review all the PXA in medical history, radiography, pathological manifestations, immunochemistry, in order to make correct diagnosis and differential diagnosis, leading to treat and predict prognosis.Results: In the 90 cases of PXA, male 47, female 43, the youngest patient is 9-months-old, the oldest is 60-year-old, and the average age is 29-year-old. About 95% of cases are supratentorial. The lesions prefer to invade the temporal lobes, including 58% of cases in all. And four cases are infratentorial. The clinical histories of the all the cases are from 1 week to 6 years. In 43% of all the cases, primary clinical manifestations are epilepsy, and 41% of the cases display the increased cranial pressure manifestation. The locations of most of the tumors are superficial, about 64% of which are cystic or cystic and solid .Solid tumors are 35%. In radiography, most of the cystic or cystic solid tumors have a large capsule with or without tubercles, which are obviously enhanced. The solid tumors usually have heterodensities with uneven enhancement. Under microscope, the tumor cells are densely arranged, which are composed of polymorphic giant bizarre cells and spindle-shaped cells .80% of the 90 cases have spumes tumorous cells, and 10 cases have anaplastic characteristics. All the cases show glial fibrillary acidic protein (GFAP) positive or local positive. Surgery is the main treatment. In this group, recurrences of PXA in the total resection and non-total resection cases are statisticly different. In contrast, the recurrences between cases which receive radiotherapy and those who don't perform that therapy have no statistic differences. The total recurrences are 36%. And the usual prognosis is good.Conclusions: The PXA is a kind of rare tumor in central nervous system, which has special location, clinical manifestations, radiography and pathological characters. The main treatment is surgery, the extent of which is in close relationship with prognosis.And the radiotherapy has no effect.