Failure to Thrive Revealing a Pilomyxoid Astrocytoma: An Uncommon Case Report with Literature Review

Abstract

Pilomyxoid astrocytoma (PMA) is a freshly described figure of low-grade neoplasms encountered in early childhood. Nevertheless, its precise classification by the World Health Organization (WHO) is still debatable. Making an exact diagnosis relies on histological and immunohistochemical pathognomonic features with specific radiological findings. PMA behaves aggressively with a shorter progression-free survival, and its management is unfortunately still arguable. We describe a rare case of PMA involving the suprasellar region who displays symptoms consistent with diencephalic syndrome. The diagnosis was made by magnetic resonance imaging (MRI) focused on the hypothalamic-pituitary axis, and the patient underwent a subtotal tumor resection combined with chemotherapy. Diagnosis of brain tumors should be kept in mind in young children with generalized and severe unexplained loss of subcutaneous fat with failure to thrive after ruling out classical causes.

The impact of extent of resection in surgical outcome of pilomyxoid astrocytoma: a case study

“…The clinical signs of PMA are similar to those of other juvenile brain tumors, such as developmental delay and altered level of awareness, in addition to hydrocephalus and widespread weakness, as well as localized neurological symptoms [6].…”

“…However, according to the 2016 modification of the WHO classification, PMA should not be automatically classified to this tumoral grade. PMA can be seen everywhere in the central nervous system, although the diencephalic region and, notably, the hypothalamic/chiasmatic area are unquestionably the most frequently observed [6].…”