PLEOMORPHIC XANTHOASTROCYTOMA - CASE-REPORT AND ANALYSIS OF THE LITERATURE CONCERNING THE EFFICACY OF RESECTION AND THE SIGNIFICANCE OF NECROSIS

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.