Pa. Pahapill et al., PLEOMORPHIC XANTHOASTROCYTOMA - CASE-REPORT AND ANALYSIS OF THE LITERATURE CONCERNING THE EFFICACY OF RESECTION AND THE SIGNIFICANCE OF NECROSIS, Neurosurgery, 38(4), 1996, pp. 822-828
THE CASE OF a patient with a pleomorphic xanthoastrocytoma (PXA), a lo
w-grade glioma of adolescence, is presented. A literature review of 79
patients with PXAs is described and confirms a favorable prognosis in
80% of patients. The sex ratio in the reported cases was almost equal
, and the median age at time of diagnosis was 14 years. Seventy-nine p
ercent of the patients presented with seizures. Nine of the 15 deaths
from PXA are associated with histological evidence of necrosis at init
ial presentation or in a recurrent tumor, confirming the poor prognosi
s associated with the presence of necrosis in these neoplasms. Surviva
l curves confirm that the optimal treatment for PXAs without necrosis
is primary surgical resection with subsequent operation for recurrent
tumor. The roles of surgery or radiotherapy in necrotic PXA are not cl
ear from the literature.