Anaplastic Pleomorphic Xanthoastrocytoma With a Component of Anaplastic Astrocytoma Presenting as Skull Base Tumor Followed by Downward Extracranial Extension : Case Report

摘要: A 16-year-old female, with unremarkable medical and family history, presented a huge dural-based mass in the right frontotemporal fossae, manifesting as headache. The patient underwent subtotal tumor resection. Intraoperative findings revealed focal erosion temporal fossa dura mater skull adjacent to lesion. Most of was located extraaxially, but part had invaded lobe, tightly adhered middle cerebral artery its perforating vessels. Histological examination cellular pleomorphism mitotic activity, necrosis, lacking endothelial proliferation, consistent anaplastic pleomorphic xanthoastrocytoma (PXA) component astrocytoma. Postoperatively, local irradiation temozolomide administration, relapsed 13 months later. Second resection performed followed by gamma knife radiosurgery, residual progressively grew, extending into contralateral hemisphere, formed an enormous left frontal lobe at 17 months. Magnetic resonance imaging 18 extracranial infiltration tumor, through cribriform plate, extension paranasal sinuses, nasal cavity, orbit during next month. died 20 after initial surgery. PXA appearance may have astrocytoma more aggressive behavior.