Images in neurology Periventricular pleomorphic xanthoastrocytoma (PXA)

The patient was a 15-year-old male with seizures. Di-agnostic imaging demonstrated a solid-cystic expansive lesion, centered on the white matter of the left temporo-occipital paratrigonal region, with growth into the ven-tricular system (Fig 1). Histological analysis led to the diagnosis of pleomor-phic xanthoastrocytoma (PXA) (Fig 2). PXA is classically a tumor with a predilection for su-perficial growth affecting young adults, and is rarely seen in paratrigonal/intraventricular locations. The tumor in this case may have arisen in and around the ventricle or from subcortical white matter. The patient has now been followed for ten years. The tumor recurred after five years without anaplastic trans-formation. He appears to be free of disease at present. REFERENCE