Cerebrospinal Fluid Spread in a Child with Pleomorphic Xanthoastrocytoma

Cerebrospinal Fluid Spread in a Child with Pleomorphic Xanthoastrocytoma: A Report with Cytopathological Evidence:



Publication date: Available online 17 October 2020

Source: World Neurosurgery

Author(s): Madhivanan Karthigeyan, Pankaj Kumar, Pravin Salunke, Manish Rohilla, Debjyoti Chatterjee, Chirag Kamal Ahuja



Abstract

Background

Pleomorphic xanthoastrocytoma (PXA), a relatively uncommon, World Health Organization grade II tumor of astrocytic origin, occurs in children and in general carries good prognosis. The recently identified anaplastic PXA (grade III) type shows poor outcome. Very rarely, the above said tumors can display an aggressive clinical course with features of leptomeningeal spread. Such cases are mostly seen in adults, with rare instances reported in pediatric age group.



Case description

In this report, we describe an 8-year-old child with anaplastic PXA with a rapid downhill course due to cerebrospinal fluid (CSF) spread. This child perhaps is the first pediatric report in which the CSF dissemination was established on cytology.



Conclusions

The case is an indicator of the need for craniospinal screening protocol in patients with PXA, especially the anaplastic variety, both at the time of initial diagnosis and follow-up.



Keywords

Pleomorphic xanthoastrocytomaAnaplasticCerebrospinal fluidCytologyleptomeningealcraniospinal

Abbreviationlist

PXAPleomorphic xanthoastrocytomaCNScentral nervous systemCSFCerebrospinal fluidCTComputed tomographyMRImagnetic resonance imaging