MELANOTIC CEREBRAL ASTROCYTOMA - CASE-REPORT AND LITERATURE-REVIEW

We describe the case of 47-year-old man with a cystic, melanotic tempo ral lobe astrocytoma who had a history of complex partial seizures. Th e tumor mass was made up of two histologically different regions: one consisted of spindle-shaped and pleomorphic cells often with foamy or vacuolated cytoplasm, while the other consisted of fairly uniform spin dle-shaped cells, many of which contained dark-brown intracytoplasmic pigment. Desmoplasia was also noted in the latter region of the tumor. No features suggestive of malignancy, such as mitotic figures, necrot ic foci or endothelial vascular proliferation, were observed throughou t the tumor. Immunohistochemically, the tumor cells in both regions we re positive for glial fibrillary acidic protein. Ultrastructural exami nation of the pigmented region showed the presence of melanosomal mela nin in the tumor cells. Apart from the partial pigmentation, the entir e histological picture resembled a pleomorphic xanthoastrocytoma. To o ur knowledge, only two cases of similar melanotic astrocytic tumors ha ve been described previously. Interestingly, the astrocytic tumors in both of these patients were also clinically associated with epilepsy, were located in the temporal lobe, and were histologically benign.