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Neurochirurgie
Volume 65, n° 1
pages 32-35 (février 2019)
Doi : 10.1016/j.neuchi.2018.12.002
Received : 6 August 2018 ;  accepted : 8 December 2018
Cas cliniques courts

Hemorrhagic presentation of frontal partially calcified pilocytic astrocytoma in an 18-year-old woman: A case report and literature review as “clinical case”
 

M. Boukobza a, , S. Goutagny b , D. Cazals-Hatem c , J.-P. Laissy a, d, e
a Department of radiology, Assistance publique–Hôpitaux de Paris, Bichat Hospital, 46, rue Henri-Huchard, 75018, Paris, France 
b Department of neurosurgery, hôpital Beaujon, Assistance publique–Hôpitaux de Paris, 92100 Clichy, France 
c Pathology department, hôpital Beaujon, Assistance publique–Hôpitaux de Paris, 92100 Clichy, France 
d INSERM U1148, 75018 Paris, France 
e University Paris 7, Faculté de Médecine Xavier-Bichat, 75018 Paris, France 

Corresponding author.
Abstract

We report an unusual case of a frontal partially calcified pilocytic astrocytoma (PA) (WHO grade 1) in an 18-year-old woman who presented with acute, spontaneous intracerebral hemorrhage. Histopathology revealed the PA was mixed with psammoma bodies and areas of vascular proliferation responsible for a hypervascular pattern. The patient underwent a total gross resection. MRI showed no residual tumor at the 18-month follow-up and her neurological deficits improved after rehabilitation. Only 20 cases, including ours, of hemorrhagic presentation of PA in adults have been reported to date with enough radiological data. Furthermore, hemorrhagic presentation of a calcified PA is extremely rare. To date only two other cases of calcified PA with hemorrhagic presentation have been reported, one in an adult and one in an infant as described by Shibao et al. (2012) and Kapoor et al. (2015) respectively. Endothelial proliferation may be the main cause of bleeding in these lesions. In our case, a hypervascular pattern was exhibited by histopathological findings. A diagnosis of PA should be considered, especially when calcifications are present within a hemorrhagic tumor lesion.

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Keywords : Pilocytic astrocytoma, Hemorrhage, Hemorrhagic tumor, Hemorrhagic pilocytic astrocytoma, Supratentorial pilocytic astrocytoma, Calcifications




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