Diagnosis of pleomorphic xanthoastrocytoma

Abstract

Introduction. Pleomorphic xanthoastrocytoma (PXA) is a rare astrocytic cancer of the central nervous system that is classified as grade II according to the WHO score. It accounts for 1% of primary brain tumors. It is mainly located in the temporal lobe and belongs to a group of tumors called long-term epilepsy associated tumors. Surgical tumor resection is the treatment of choice.

Brief description of the state of knowledge. The non-invasive method of PXA diagnostics is neuroimaging, which is based on computer tomography (CT) and magnetic resonance imaging (MRI). In the image, PXA presents as a solid tumor undergoing contrast enhancement, located supratentorial, with frequent peripheral cystic components.

The characteristic histologic picture for PXA is the presence of highly pleomorphic, fusiform or round, large astrocytes with single or multiple cell nuclei. Lymphoplasmic infiltrates are visible within the tumor. The most common mutations associated with the occurrence of this cancer are mutations in the BRAF V600E gene.

Conclusions. PXA is a very rare tumor of the central nervous system (CNS) that can recur and spread throughout the CNS. Imaging tests, i.e. CT and MRI, allow for precise imaging of the lesion, however, it is necessary to perform a histopathological examination to make a final diagnosis. The rarity of this cancer assimilates diagnostic problems. Therefore, further molecular research is needed to develop more efficient diagnostics.