Pleomorphic xanthoastrocytoma

Case contributed by Dr Mohammad A. ElBeialy


2-year history of seizures and chronic headache.

Patient Data

Age: 30 years
Gender: Female

A right temporal lobe cortical based lobulated cystic mass lesion with enhancing mural nodule. The solid nodule of the lesion shows isointense T1 and T2 signal with intense homogenous post-contrast enhancement. The cystic component of the lesion shows low T1 and high T2 signal with marginal post-contrast enhancement. The lesion is associated with mild vasogenic brain edema with mild compression of the right lateral ventricle’s temporal horn and some effacement of cortical sulci.

Case Discussion

A right temporal based cystic mass lesion with enhancing mural nodule has a differential that includes pleomorphic xanthoastrocytoma (PXA), ganglioglioma or less likely dysembryoplastic neuroepithelial tumor (DNET).

Unfortunately, histological confirmation of the diagnosis is not available in this case. 

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