A rare case of cerebellar anaplastic pleomorphic xanthoastrocytoma

Pleomorphic xanthoastrocytoma (PXA) is a low-grade glioma comprising 1% of all astrocytomas with an extremely rare anaplastic counterpart usually found in young adults. These tumors are most often cerebral in origin and their presentation in the elderly signifies poor prognosis. As these tumors are an important differential of glioblastoma, diagnosing them accurately is essential for management. We present a 68-year-male with positive cerebellar signs and clinico-radiological impression of cerebellar metastatic deposits, subsequently diagnosed as cerebellar PXA with anaplastic features. The case in discussion is unique in its age, site, and grade of presentation, with key histological features rebuking the clinical and radiological diagnosis of metastasis. The rarity and ambiguous management protocol of these tumors make their documentation an important addition to the existing literature with emphasis on possibility of late presentation and at sites other than the cerebrum.