Recurrent Pleomorphic Xanthoastrocytoma Presenting With Diffuse Leptomeningeal Spread

Area of Science:

• Neuro-oncology
• Neuropathology
• Neurosurgery

Background:

• Pleomorphic xanthoastrocytoma (PXA) is a rare glial tumor typically affecting young adults.
• Recurrence and leptomeningeal dissemination are uncommon but serious complications of PXA.
• Accurate diagnosis and characterization are crucial for effective management.

Purpose of the Study:

• To present a case of recurrent pleomorphic xanthoastrocytoma with leptomeningeal spread.
• To highlight the characteristic clinical, cerebrospinal fluid (CSF), and imaging findings associated with this rare presentation.
• To underscore the importance of comprehensive diagnostic evaluation in managing complex PXA cases.

Main Methods:

• Detailed clinical case presentation.
• Analysis of cerebrospinal fluid (CSF) cytology and biochemistry.
• Review of neuroimaging studies including MRI and CT scans.

Main Results:

• The patient presented with specific neurological deficits and symptoms.
• CSF analysis revealed malignant cells consistent with leptomeningeal spread.
• Imaging demonstrated characteristic features of recurrent PXA with leptomeningeal involvement.

Conclusions:

• Recurrent pleomorphic xanthoastrocytoma with leptomeningeal spread presents with a distinct set of clinical, CSF, and imaging findings.
• Early recognition of these findings is vital for timely intervention and improved patient outcomes.
• This case emphasizes the need for vigilance in monitoring for rare but aggressive patterns of PXA progression.