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Pilocytic astrocytoma: unusual feature
S Berroir1, F Lafitte, F Héran
1Services d'imagerie médicale, Fondation ophtalmologique A. de Rothschild, 19-25, rue Manin, 75019 Paris, France.
Insights
Juvenile pilocytic astrocytoma, a common pediatric brain tumor, can rarely occur in adults. This case highlights a posterior fossa pilocytic astrocytoma in a 42-year-old, emphasizing its unusual presentation in adults.
Area of Science:
- Neuro-oncology
- Pediatric Neurosurgery
- Neuroradiology
Background:
- Juvenile pilocytic astrocytoma (JPA) is a well-defined, common brain tumor primarily affecting children and young adults.
- JPAs typically present in the posterior fossa with characteristic cystic and enhancing mural nodule imaging features.
- Complete surgical resection of JPA generally leads to an excellent prognosis.
Observation:
- Adult cases of JPA are rare and predominantly occur in the cerebral hemispheres.
- This report details a unique case of a 42-year-old male with a large, heterogeneous posterior fossa lesion.
- The lesion's location and imaging characteristics were atypical for adult brain tumors.
Findings:
- Histopathological analysis confirmed the lesion as a juvenile pilocytic astrocytoma.
- The adult posterior fossa presentation mimicked infectious lesions, posing a diagnostic challenge.
- This case underscores the importance of considering JPA in atypical adult presentations.
Implications:
- Recognizing JPA in adults, especially with posterior fossa involvement, is crucial for accurate diagnosis.
- Atypical presentations of JPA in adults can be misdiagnosed as infectious etiologies.
- This case expands the understanding of JPA's clinical spectrum and diagnostic considerations in adult neuro-oncology.
Abstract:
Juvenile pilocytic astrocytoma is a well-defined brain tumor. It most often occurs in children and young adults. It is located in the posterior fossa and has typical imaging features, associating cystic and strongly contrast enhancing mural nodule. After complete surgical removal, its prognosis is excellent. Adult cases are seldom observed. They develop almost exclusively within the cerebral hemispheres and share the same imaging and prognostic characteristics as the pediatric forms. We describe the case of a 42-years-old man presenting with a huge heterogenous posterior fossa lesion. Histopathological analysis of the lesion after surgical resection diagnosed a juvenile pilocytic astrocytoma. These peculiar location and imaging features in an adult patient may be misdiagnosed for infectious lesions and must be recognized.