Periventricular pleomorphic xanthoastrocytoma (PXA): an uncommon tumor at an atypical site

Abstract

The patient was a 15-year-old male with seizures. Diagnostic imaging demonstrated a solid-cystic expansive lesion, centered on the white matter of the left temporooccipital paratrigonal region, with growth into the ventricular system (Fig 1). Histological analysis led to the diagnosis of pleomorphic xanthoastrocytoma (PXA) (Fig 2). PXA is classically a tumor with a predilection for superficial growth affecting young adults, and is rarely seen in paratrigonal/intraventricular locations. The tumor in this case may have arisen in and around the ventricle or from subcortical white matter. The patient has now been followed for ten years. The tumor recurred after five years without anaplastic transformation. He appears to be free of disease at present.