Presentation
Headache and blurred vision. Hypothalamic tumour. Right frontal VAD. Biopsy. Left occipital VP shunt.
Patient Data
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Large enhancing tumour centred in the hypothalamic region. Heterogeneous contrast enhancement. Obstructive hydrocephalus. No other abnormality.
Right frontal VAD. Left occipital VP shunt.
PATHOLOGY
Sections show fragments of a glial tumour composed of elongated bipolar piloid cells arranged in a composite solid and loose architecture. Nuclear pleomorphism is not marked.Mitotic activity is inconspicuous. No evidence of necrosis. No well-formed Rosenthal fibres or eosinophilic granular bodies.
Strong expression: glial fibrillary acidic protein and S100 protein
Negative reaction: antibodies to IDH1 and epithelial membrane antigen.
Cell proliferation index (MIB1 antibody) is overall low.
Pilocytic astrocytoma WHO Grade 1.